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Definition

A stroke happens when blood flow to a child’s brain is blocked. Brain tissue that doesn’t get enough oxygen from blood can die within minutes.

There are 3 types of strokes in children:

Causes

Blood flow may be blocked by:

  • A blood clot from other parts of the body, such as the heart
  • A narrow blood vessel
  • A blood vessel that breaks

A blockage in a small blood vessel will affect a smaller area of the brain. A blockage in a larger blood vessel will block flow to many smaller blood vessels. This will affect more of the brain.

The cause of some strokes in children is not known.

Risk Factors

Factors that may increase your child’s risk of stroke are:

  • Abnormal heart
  • Blood clotting problems, such as hemophilia
  • Blood disorders, such as sickle cell disease
  • Infections, such as bacterial meningitis or gastroenteritis
  • Severe dehydration
  • Head injury
  • Recent heart treatments or surgery
  • Certain medicines

Symptoms

Most symptoms start suddenly. Symptoms can also happen for a short time and then go away.

Your child may have:

  • Weakness on 1 side of the body, such as an uneven smile
  • Problems speaking
  • Eyesight problems
  • A feeling that the room is spinning
  • Balance problems and problems walking
  • A sudden, severe headache
  • Confusion
  • Extreme sleepiness
  • Seizures
  • Behavior or personality changes

Diagnosis

You will be asked about your child’s symptoms and past health. An exam will be done including a check of the nervous system.

Images of the brain can show how much of the brain is affected. This can be done with:

An EEG may also be done. It can help to check electrical activity in the brain.

Other tests may be done to help find a cause.

Treatment

Your child will need to be treated right away. Damage to the brain can be reduced if blood flow is improved quickly.

The treatment plan will depend on your child’s needs. Options include:

Supportive Care

Your child will be watched closely. Care will be given to keep your child stable.

Your child may be given:

Your child will be watched closely. Care will be given to keep your child stable.

Your child may be given:

  • Oxygen—to increase oxygen levels to the brain
  • IV fluids

Medicines

Your child may be given:

Your child may be given:

  • Anticonvulsants to control seizures
  • Blood thinners

Surgery

Pressure on the brain may be increased due to stroke or swelling. This will lead to more brain damage. Surgery may be done to ease pressure on the brain.

Pressure on the brain may be increased due to stroke or swelling. This will lead to more brain damage. Surgery may be done to ease pressure on the brain.

Rehabilitation

There may be some problems after the stroke. Some may recover later and recover with rehab. Others may have permanent changes. In this case, rehab will help your child adjust and limit disability. Options include:

There may be some problems after the stroke. Some may recover later and recover with rehab. Others may have permanent changes. In this case, rehab will help your child adjust and limit disability. Options include:

  • Physical therapy
  • Occupational therapy—to help with everyday tasks
  • Speech therapy—to improve speech problems

Prevention

Not all strokes can be prevented. If your child has a medical condition that is linked to strokes, follow your care plan. This may help lower the risk of a stroke.

RESOURCES

American Stroke Association  https://www.strokeassociation.org 

Healthy Children—American Academy of Pediatrics  http://www.healthychildren.org 

CANADIAN RESOURCES

Health Canada  http://www.canada.ca 

SickKids—The Hospital for Sick Kids  https://www.sickkids.ca 

References

Pediatric stroke. American Stroke Association website. Available at: https://www.strokeassociation.org/STROKEORG/AboutStroke/StrokeInChildren/Stroke-In-Children%5FUCM%5F308543%5FSubHomePage.jsp#. Accessed November 29, 2019.

Pediatric stroke. Children’s Hemiplegia and Stroke Association website. Available at: https://chasa.org/medical/pediatric-stroke/. Accessed November 29, 2019.

Pediatric stroke. Children’s Hospital of Philadelphia website. Available at: https://www.chop.edu/conditions-diseases/pediatric-stroke. Accessed November 29, 2019.

Perinatal stroke. EBSCO DynaMed website. Available at:  https://www.dynamed.com/condition/perinatal-stroke . Updated July 10, 2015. Accessed November 29, 2019.

Stroke in children. Child Neurology Foundation website. Available at: http://www.childneurologyfoundation.org/disorders/stroke-in-children/. Accessed November 29, 2019.

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