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Pediatric Stroke

What Is Pediatric Stroke?

IF YOU SUSPECT YOUR CHILD IS HAVING A STROKE, CALL 911 IMMEDIATELY.

Pediatric stroke is a rare condition affecting one in every 4,000 newborns and an additional 2,000 older children each year. Stroke is a type of cerebrovascular disorder; this group of conditions is among the top 10 causes of death in children.

As in the case of adults, without prompt and appropriate treatment, stroke in children can be life-threatening. Pediatric stroke can also cause neurologic disability, including the risk of long-term cognitive and motor impairment.

Strokes can be categorized as ischemic (caused by insufficient blood flow) and hemorrhagic (caused by bleeding into the brain.) Treatments and long-term outcome in children are different for each type.

What Are the Signs and Symptoms of Pediatric Stroke?

Stroke in children typically begins suddenly. Symptoms may include (but are not limited to) the following:

  • Weakness or numbness on one side of the body
  • Slurred speech or difficulty with language
  • Trouble balancing or walking
  • Vision problems, such as double vision or loss of vision
  • Sudden lethargy or drowsiness
  • Seizure affecting one side of the body.

What Are the Risk Factors for Pediatric Stroke?

Causes of stroke in children are different from those in adults. Risk factors include:

  • Heart disease
  • Problems with blood vessels supplying the brain
  • Blood clotting disorders
  • Sickle cell disease

Pediatric Stroke Diagnosis

When a child experiences symptoms that may indicate a stroke, rapid and thorough evaluation by a pediatrician or neurologist is essential to initiate treatment quickly and lower the risk of long-term problems.

Imaging studies of the brain and blood vessels, such as magnetic resonance imaging (MRI) are essential for diagnosis.

Additional testing to find the cause of the stroke may include:

  • Catheter angiogram
  • Heart ultrasound (echocardiogram)
  • Blood tests for clotting disorders

Your child may need to see other specialists to help identify the cause of the stroke. For example, if the stroke is thought to be caused by a blood clot, a hematologist may join your child’s care team.

Pediatric Stroke Treatment

In the early stages of a stroke, your child’s treatment centers around supporting blood flow to the brain. Treatment may be a combination of the following:

Medical therapy: Your child may receive aspirin or other blood thinners (anticoagulants) and special vitamins. Children with sickle cell disease and stroke may be treated with hydroxyurea, transfusion therapy or both. If the stroke is causing seizures, your child may need antiseizure medication as well.

“Clot-busting” medications used successfully in adults have not yet been approved for use in children, but they may be considered in certain situations.

Interventional neuroradiology: If your child has abnormal blood vessels that feed the brain (arteriovenous malformation) or blood vessels with weakened walls that can bulge and tear (aneurysm), the doctor may place a catheter inside the affected blood vessel to restore essential blood flow to the brain without surgery.

Surgery: A surgical procedure may be appropriate in certain types of strokes and other cerebrovascular disorders.

Pediatric Stroke Recovery

Follow-up care is extremely important. Once your child is stabilized, your medical team will work with you to create an ongoing plan to assess your child’s function and optimize recovery.

Depending on which side of the brain the stroke occurred, your child may experience difficulties with walking, seeing, speaking or reading, sometimes with one side of the body affected more than the other. The stroke may cause a seizure disorder or have an impact on your child’s thinking or emotions.

Overall, a child’s growing brain has a better chance of recovering from stroke than an adult’s brain. Prompt diagnosis and treatment can minimize the risk of lasting problems, and early rehabilitation can help to maximize recovery.

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