Stroke guidelines should be updated to recommend thrombectomy ahead of conservative treatment in children with large vessel occlusion stroke, Australian paediatric neurologists say.

Given the severity of the neurological syndrome in affected patients, treatment pathways should also be streamlined to better facilitate timely intervention, they say.

The call follows a retrospective, population-based study designed to shed light on the natural history of large vessel occlusion (LVO) stroke, which drew on NSW hospital data for arterial ischaemic stroke in patients aged 1-17 years.

With a mean follow-up of three years, the study showed that those with LVO stroke treated conservatively had far worse functional outcomes than those who received thrombectomy, “contrary to historic beliefs”, the researchers said.