2025 Annual Report

NEW PROGRAMS

90 total Code Stroke calls from September 2024 to December 2025 15 % of these Code Strokes have identified ischemic or hemorrhagic strokes

This Code Stroke effort was spearheaded by Drs. Novara and Tofil and Jeffrey Blount, M.D., MPH, professor in the Division of Pediatric Neurosurgery, and included colleagues from pediatric emergency medicine, neuro-interventionalists, radiology, nursing, and operators. After the Code Stroke protocol was established and education was provided across the pediatric divisions, the Children’s of Alabama Code Stroke went live in September 2024. As of December 2025, a Code Stroke has been called 90 times (either in the ED or on a hospital floor). Approximately 15% of these Code Strokes have identified ischemic or hemorrhagic strokes, allowing for efficient evaluation and management. Several of the pediatric acute ischemic stroke patients have even benefited from an acute thrombectomy performed by the on-call neuro interventionalists. Code Stroke patients with hemorrhagic stroke have benefited from the expedited care of the pediatric neurosurgery team. Many of the Code Stroke patients have made remarkable recoveries.

“The Code Stroke working group meets quarterly to continuously discuss ways in which to improve our Code Stroke protocol and to collaborate together as we try to provide the best care for our patients,” explains Tofil.

EXPANDING CARE BEYOND THE ACUTE PHASE: PEDIATRIC STROKE CLINIC

In early 2025, a monthly Stroke Clinic was established by Drs. Novara and McGrath to provide a unique pediatric stroke follow-up clinic that offers ongoing patient support, education, and follow-up care, including best efforts at secondary stroke prevention. In the monthly stroke clinic, the pediatric neurology team collaborates with pediatric hematology and neurosurgery colleagues in the care of unique pediatric patient populations seen in their clinics who are at risk for stroke. The stroke clinic also allows the pediatric neurology team to provide effective transition of care for patients from pediatric to adult stroke care at UAB as needed. The pediatric stroke clinic at Children’s of Alabama is a participating site within the International Pediatric Stroke Study, which is a research group working hard within the International Pediatric Stroke Organization to expand the knowledge about pediatric stroke and best practices for these unique patients. The Code Stroke program has demonstrated that targeted educational initiatives, combined with the development of standardized, multidisciplinary response protocols, can meaningfully improve the evaluation and management of children presenting with possible pediatric strokes. As awareness grows and standardized care pathways expand, there is an opportunity to reduce the burden of pediatric stroke and ensure that children receive timely, evidence-informed care when minutes matter most. ●

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