When most people think of strokes, they think of adults. But your child can also be at risk of developing a stroke. Although strokes are less common in children, they can happen in children at any age. They may even happen before your child is born. Pediatric stroke affects one in every 4,000 newborns and an additional 2,000 older children each year, according to John Hopkins Medicine.
Although strokes can affect older children as well, most of them are caused by another condition that stops the flow of blood to the brain or causes bleeding in the brain.
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Types of pediatric stroke
The Children’s Hospital of Pittsburgh UPMC notes six types of strokes that are most common in children:
- Perinatal (newborn) stroke — Strokes in newborns are common and often go unnoticed and undiagnosed.
- Hemorrhagic stroke — This stroke occurs when a blood vessel in or near the brain ruptures, causing bleeding in the brain.
- Ischemic stroke — An ischemic stroke occurs when the blood flow to the brain is diminished, usually because of a clot, called a thrombus, in one of the blood vessels in the brain. There are two types of ischemic stroke that occur in children, especially newborns: sinovenous thrombosis and arterial ischemic stroke.
- Sinovenous thrombosis stroke — This stroke occurs when there is a clot in one of the veins in the brain.
- Arterial ischemic stroke — This stroke occurs when there is a clot in an artery in the brain.
- Cerebral venous thrombosis (CVT) — CVT is a stroke that results from thrombosis (a blood clot) in the dural venous sinuses, which drain blood from the brain.
What causes pediatric strokes?
Ischemic strokes are caused by the following:
- lack of oxygen during birth
- a heart defect the baby is born with
- blood disorders such as sickle cell disease, which destroys blood cells and blocks blood vessels
- injury to an artery (a blood vessel that brings oxygen) in the brain
- dehydration
- genetic disorders like Moyamoya, a rare disease that affects arteries in the brain
- an infection, such as meningitis or chickenpox
READ: Is Your Baby’s Heart Healthy?
Newborns can develop an ischemic stroke due to the following pregnancy complications:
- preeclampsia (high blood pressure during pregnancy that can cause swelling in the hands, feet, and legs)
- premature rupture of the membranes (when a woman’s water breaks more than 24 hours before labor starts)
- diabetes
- infections
- drug abuse
- placenta problems that decrease the baby’s oxygen supply, such as placental abruption
Hemorrhagic strokes are caused by the following:
- a head injury that causes a broken blood vessel
- arteriovenous malformation, a condition in which the blood vessels in the brain don’t connect properly
- an aneurysm (weakness in an artery wall)
- diseases that affect blood clotting, such as hemophilia
What are the signs and symptoms of pediatric strokes?
Signs that an older child is having a stroke are usually the same ones you may see in an adult:
- sudden weakness
- slurred speech
- blurred vision
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Seizures may also be a sign of stroke in older children. Your child may have sudden paralysis (inability to move) or weakness on one side of their body, depending on the area of the brain that’s affected and the amount of damage the stroke causes. You may notice changes in your child’s behavior, concentration, memory, or speech.
Signs of a stroke in infants include:
- seizures in one area of the body, such as an arm or a leg
- problems eating
- trouble breathing or pauses in breathing (apnea)
- early preference for use of one hand over the other
- developmental delays, such as rolling over and crawling later than usual
Babies who suffer from a pediatric stroke don’t usually show symptoms until months or years down the line. Your child may still develop normally, but at a slower rate and favor one hand more than the other.
The following are signs of stroke in kids and teens:
- seizures
- headaches, possibly with vomiting
- sudden paralysis or weakness on one side of the body
- language or speech delays or changes, such as slurring
- trouble swallowing
- vision problems, such as blurred or double vision
- tendency to not use one of their arms or hands
- tightness or restricted movement in the arms and legs
- trouble with schoolwork
- memory loss
- sudden mood or behavioral changes
Diagnosis and treatment
Strokes are often hard to diagnose in children because they may show no clear symptoms. In a lot of cases, children aren’t diagnosed until after they have suffered several seizures and developmental delays.
If you suspect your child may have suffered from a stroke, you should contact your child’s doctor immediately and him them run tests.
What you can do (management and treatment)
Brain damage from a stroke can cause a number of problems including:
- cerebral palsy
- cognitive and learning problems
- paralysis or weakness on one side
- communication problems
- vision problems
- psychological problems
If your child develops any of these problems, you should consult with a specialist that may help them.
The most common treatments for children who suffer from a stroke are medicine, procedures, surgery and rehabilitation. A physiatrist may also try different types of therapy to restore your child’s functional ability and quality of life.
The goal of the doctors is to treat whatever condition may have led to your child’s stroke and prevent a second stroke.
Although preventing pediatric strokes may be difficult because warnings may not appear until after the first stroke, most children recover. As a parent, your goal will be to support your child during their recovery. This involves helping them with their rehabilitation process as they re-learn how to use body functions such as speech and vision following a stroke.