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Stroke in Children: What You Need to Know

Reviewed by Dan Brennan, MD on March 16, 2021

If you suspect your child is having a stroke, it is a medical emergency, and you should call 911 immediately. 

When you hear the word “stroke,” you probably think it's a health problem that mainly affects older people. However, strokes can happen at any age, including during childhood. Stroke is one of the top 10 causes of death for children every year.

Getting help quickly is the best thing you can do for a child who is having a stroke. Quick treatment can save your child’s life. Learn about the signs of stroke in children. 

What is a Stroke?

A stroke is what happens when blood is cut off to one part of the brain. When this happens, the cells in the affected part of the brain start to die. Strokes can result in permanent brain damage, though some people have partial or full recoveries after a stroke. There are different types of strokes that affect children: 

Arterial ischemic stroke.  Arteries are the vessels that carry oxygen-filled blood from the heart to other parts of the body. A blot clot or other type of blockage in an artery can cause a stroke. The blockage prevents blood from flowing normally to parts of the brain.

Continued

Intracranial hemorrhage. This is known as bleeding in the brain. When a blood vessel is damaged, and blood leaks out, it can cause a stroke.

Cerebral sinovenous thrombosis. Blood clots can happen in veins, which are the vessels that take blood back to the heart to get more oxygen. Clots in veins near the brain can sometimes cause a stroke. Clots like this may clear on their own without doing any lasting damage.

Who Is At Risk?

Most children have a very low risk of stroke. Newborn babies have a greater stroke risk than older children. As many as 1 in 2500 infants have strokes within their first 28 days after being born. Premature infants have a higher stroke risk than babies born closer to their due dates. Babies can have strokes before they are born.

Older children rarely have a stroke. Only about 12 in 100,000 children will ever have a stroke before they turn 18. Certain health conditions can increase a child’s risk of having a stroke while they are young, including:

  • Sickle cell anemia 
  • Congenital heart defects
  • Immune disorders
  • Problems with blood clotting
  • Narrow blood vessels

Signs and Symptoms of Stroke in Children

Because stroke in children is so uncommon, parents and doctors can miss the signs. It may be harder to notice signs of a stroke in children too young to speak. In some cases, doctors may only realize a baby has had a stroke months after it happened.

Signs of a stroke in babies and young children can include:

  • Seizures
  • Extreme sleepiness
  • A tendency to use only one side of their body
  • Developmental delays  

Older children can tell parents about their symptoms. Some of the signs of a stroke in older children and teens include:

  • Severe headache combined with vomiting and sleepiness
  • Weakness or numbness on one side of the body, particularly the face, arm, and leg
  • Sudden changes in speech including problems understanding language, slurred or difficult speech, inability to speak at all
  • Sudden changes in vision in one or both eyes
  • Sudden, severe dizziness or loss of coordination 
  • Seizures that may affect just one side of the body and might be followed by paralysis on the same side as the seizure

Treatment for Stroke

If you suspect your child is having a stroke, it is a medical emergency, and you should call 911 immediately. 

Doctors have several possible treatments for stroke. To get the blood flowing normally to your child’s brain as quickly as possible, they may give your child medicine such as aspirin or blood thinners to increase blood flow. These are drugs known as “clot busters,” and they're used for adults during strokes, but these medications are not approved for children. There are times that a doctor might decide using one of these medications is appropriate for the situation.

In some cases, doctors may place a tube called a catheter inside one of your child's blood vessels to restore normal blood flow. The doctors can insert the catheter into a blood vessel in your child’s arm or leg then thread it up to the place where the stroke is occurring. The catheter may break or dislodge the clot, or it can support a weak spot in the blood vessel to prevent bleeding.

At other times, the best treatment for a stroke is surgery. Doctors may need to operate on your child’s brain to repair the damage to the blood vessels. Surgery can also help with swelling and pressure on the brain.

Recovering from Stroke

The recovery from a stroke is different for every person. After your child is out of danger, you should work with their doctor to make a plan for follow-up care. Your child might need physical and occupational therapy to help with regaining skills.

Some children need speech therapy to improve their speech after a stroke. They may require extra assistance with schoolwork if the stroke causes learning changes. Some children have trouble regulating their emotions after a stroke and may need to work with therapists on managing their moods.

Children often have a better chance of full recovery after a stroke than an adult would. Growing brains can repair the damage caused by a stroke, or children can learn new ways of managing after a stroke. Your child’s doctor can help you map out a path to the best recovery possible.

WebMD Medical Reference

Sources

SOURCES:

Boston Children’s Hospital: “Neonatal Stroke.”

Children’s Hospital of Philadelphia: “Pediatric Stroke.”

Johns Hopkins Medicine: “Pediatric Stroke.”

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