Contrary to what most people think, stroke is a condition that can strike any age group, including unborn babies, infants and young children. In fact, it is one of the 10 leading causes of death in children, affecting 6 out of 100,000 children in the United States, according to the National Stroke Association.
While more adults are affected by stroke, recent studies have found that the incidence of stroke in children is much higher than previously estimated. A 2011 study published in the Annals of Neurology reported that there was a 51% increase in the incidence of ischemic stroke in boys aged 5 to 14 from 1995 to 2008, while girls aged 5 to 14 years saw a 3% increase in the same period.
Stroke is a life-threatening condition that requires immediate medical attention. Early recognition and treatment is critical in arresting long-term deficits and recurrence risks. But because most parents, caregivers and even health professionals do not associate stroke with children and because the early signs of stroke are different in children than in adults, the recognition of childhood stroke is often missed or delayed.
Understanding what childhood stroke is, its representations, the risks and treatment options may spell the difference between life and death or long-term cognitive, behavioral and functional deficits in your child.
Types of Childhood Stroke
Perinatal stroke
Also referred to as prenatal or fetal stroke, refers to the last 18 weeks of pregnancy through the first 30 days of birth. Perinatal stroke occurs in one out every 2,800 live births in the United States.
Perinatal strokes are often ischemic caused by blood clots that broke off from the placenta and got lodged in the baby’s brain.
Childhood stroke
Occurs between the ages 1 month and 18 years. Almost 60% of all childhood strokes in the United States occur in boys.
Children are equally likely to have ischemic strokes as they are likely to have hemorrhagic strokes, or strokes caused by a ruptured blood vessel resulting in bleeding in the brain.
What are the risk factors for pediatric stroke?
According to the International Alliance for Pediatric Stroke, the children at risk of pediatric stroke include:
New borns, particularly full-term infants
Older children with an underlying condition, such as sickle cell anemia, congenital heart defects blood clotting disorders, autoimmune disorders, head and neck infections and head trauma
Children with hidden disorders, such as narrow blood vessels or have a tendency to form blood clots easily
In most cases, however, no previous risk factor can be determined.
What to look out for?
The early signs of stroke in children are much more subtle than in adults, hence they are often unrecognized. Most children with stroke symptoms are misdiagnosed with common conditions that mimic stroke, such as migraines, epilepsy or viral infections.
Signs of stroke in newborns and infants to watch out for include:
Repetitive twitching of the face, arm or leg
A long pause in breathing together with prolonged staring
Seizures
Extreme sleepiness
Tendency to use just one side of the body
Parents may not know that their baby suffered stroke until months later when the infant shows decreased movement or weakness in one side of the body. Showing hand preference or consistently reaching out with one hand in infants less than a year old may also be a sign of perinatal stroke.
As children get older, the signs and symptoms of stroke become similar to those in adults. These include:
Weakness or numbness of the face, arm or leg, very often on one side of the body
Problems speaking or understanding language (e.g. slurred speech or difficulty understanding simple instructions )
Severe headache accompanied with vomiting and sleepiness
Severe dizziness or loss of coordination that could lead to loss of balance
Difficulty seeing clearly in one or both eyes
Seizures, particularly if affecting just one part of the body and followed by paralysis on the side affected by the seizure
What you can do
Act fast and call your emergency services or go to the nearest hospital emergency department. Every second counts. Getting to the hospital quickly is the first step to providing treatment and mitigating any long-term deficits.
The American Stroke Association has easy way to recall the sudden signs of stroke in both children and adults:
F – Face drooping
A – arm weakness
S – slurred speech
T – time to call 911
While waiting for emergency services, ask your child to lie flat on the floor. Keep them comfortable and supported. Check their breathing, pulse and responsiveness. Do not give your child anything to eat or drink as they may have difficulty swallowing and they might choke.
Sixty percent of children who survive stroke will have permanent neurological problems, most commonly hemiplegia or hemiparesis or total or partial paralysis on one side of the body. Other long-term deficits and disabilities caused by childhood stroke include speech or communication disorder, cognitive disorders, sensory impairments, poor attention, behavioral problems, epilepsy and poor quality of life.