Mark MacKay FRACP

Childhood Stroke: early recognition and intervention

Mark trained in General Paediatrics in Sydney and Melbourne. He trained in paediatric Neurology under the mentorship of Drs. Lloyd Shield and Simon Harvey at Royal Children’s Hospital, Melbourne. He also trained in Adult Stroke Medicine in Melbourne before completing 2 years of paediatric neurology and epilepsy training at the Hospital for Sick Children in Toronto. In 2001, he became a consultant in Child Neurology in Royal Children’s Melbourne and has since developed an interest in stroke medicine.

Interview by Russell Dale, 26 November 2013


What was it that made you interested in stroke?

I became interested in stroke during my year as stroke registrar at the Austin Hospital. This was further developed through my work with Paul Monagle and subsequently through contact with Gabrielle deVeber in Toronto. I joined the International Paediatric Stroke Research Group in 2003 and then set up a clinical paediatric stroke service in Melbourne in 2004. As part of that I set up a parallel research programme and subsequently started a part time PhD in 2009. I am hoping to write up and submit my thesis within the next 6 months. My PhD is aimed to improve the accuracy and timeliness of stroke diagnosis in children.


What have been the main achievements of the Paediatric International Stroke Group?

The first thing it has achieved is to create a vehicle for collaborative research. Gabrielle deVeber leadership has bound the group together. The focus has shifted from collecting registry data to development of hypothesis driven research questions. This has been successful and resulted in three NIH funded studies. It has been good to be part of a North American centric research group.


ANZCNS Research hopes to create multicentre research opportunities. What could be achieved in paediatric stroke research in Australia and New Zealand?

I have 2, 5, and 10 year plans. The first step is the formation of a collaborative group to generate and publish pilot data from Australian and New Zealand childhood stroke population. This will facilitate application for seed funding for small projects. My hope is that this collaboration will build into a well-developed research network that could get NHMRC funding. The initial aim would be to pilot a clinical tool that could predict the likelihood of childhood stroke to reduce delays to stroke diagnosis in children, thereby allowing timely therapeutic intervention. Another area of importance is neonatal stroke and it would be good to develop a nationwide approach to reducing the morbidity of neonatal stroke.


What do you think are the main barriers to such research endeavours?

The main barrier is the lack of protected time for research. I am fortunate to have the support of a Head of Department who prioritises research and understands that research enhances the department’s international reputation. Another barrier is the lack of support staff available such as nurse specialists and research coordinators to help with administration and ethics applications. I am fortunate to have a nurse coordinator who has made a big difference.


Can you identify collaborators in each centre in Australia and New Zealand?

Yes, I have already had informal discussions with some people. It would be great to identify a trainee with an interest in this area to develop a multicentre project.


Do you think research should be a requirement in child neurology training or just encouraged?

I personally think research should be a training requirement because there is a great opportunity and scope for high quality research in Australia and New Zealand due to the centralised nature of specialised services.


Thanks Mark, and good luck with the thesis submission.

You are welcome.