While adults are at a higher risk for stroke, children of all ages can have strokes too, even in utero. In fact, according to the National Stroke Association
, strokes affect about six in 100,000 children and 60 percent of pediatric strokes occur in boys.
May is American Stroke Month, and a good time to brush up on pediatric stroke education and awareness. We asked pediatric neurologist Jessica Carpenter, MD
, to explain how strokes are different in children than adults and the signs of stroke in children.How Pediatric Strokes are Different
Strokes affect children differently than adults when it comes to their risk factors and recovery, Dr. Carpenter noted. For adults, lifestyle choices tend to cause risk factors like high blood pressure or high cholesterol that eventually lead to stroke.
“The causes of stroke in children are different from adults and usually not attributable to lifestyle choices,” Dr. Carpenter said.
In children, perinatal strokes are among the most common. Perinatal strokes are those that occur before, during, or after birth and the cause for this type of stroke is often unknown, explained Dr. Carpenter, who directs the Neonatal and Childhood Stroke Program at Children’s National.
Arterial ischemic (AIS) strokes can be caused by the narrowing and/or blockage of a blood vessel resulting in a lack of oxygen to the brain. This can happen when the blood vessel is narrowed and/or when a blood clot blocks an otherwise normal vessel. There is a risk for this to happen after trauma, an acute or chronic illness with inflammation, or heart problems.
Hemorrhagic strokes are most often caused by ruptured, weakened, or malformed arteries (e.g. arteriovenous malformations (AVMs)). High blood pressure and aneurysms are common causes of this type of stroke in adults, but are rare in children. Cerebral sinovenous thrombosis (CSVT) is a stroke type that results when blood clots develop in the veins draining blood from the head. CSVT is associated with clotting disorders, head and neck infections, and trauma.
In terms of recovery, Dr. Carpenter noted that children have a better ability to recover from a stroke than an adult because a child’s brain is still developing and has more plasticity.
Recognizing the Signs of Stroke
It’s important that parents and caregivers can recognize the signs of a stroke and be able to take immediate action to reduce complications and the risk of permanent disability.
According to Dr. Carpenter and the National Stroke Association, signs of stroke include:
- Onset of acute weakness, usually on one side
- Sudden inability to speak or follow directions
- Worsening or sudden headaches
- Sudden loss of vision or abnormal eye movements
- Sudden loss of balance or trouble walking
If a child is experiencing any of these symptoms, parents should immediately contact their child’s pediatrician or dial 911.
“Knowing and recognizing the signs of stroke can help parents identify it early on,” Dr. Carpenter said.Treating Pediatric Stroke
Treatment options for stroke vary and are often dependent on a child’s age, their signs and symptoms, and any other ongoing acute or chronic illness that may have caused the stroke.
Treatment may include giving fluids to avoid or reverse dehydration, giving oxygen, blood transfusions, treatment of a heart condition, medication to treat abnormal blood clotting, and even surgery.
The Neonatal and Childhood Stroke Program at Children’s National is one of the few comprehensive stroke teams in the country skilled in the diagnosis of stroke, identification of causes of stroke in children, and appropriate interventions to prevent secondary injury. The team also includes rehabilitation doctors who work with specifically with children to maximize recovery after a stroke.
Sickle Cell Disease and Stroke
Stroke is a major complication of sickle cell disease, putting children with the disease at a higher risk for stroke than children in general. Children’s National’s Sickle Cell Disease Program is among the largest pediatric sickle cell disease programs in the country. Each year, we treat more than 1,400 children and young adults with various types of the disease.
In addition, children who have had one stroke from sickle cell anemia are more likely to have a second or third. At Children’s National, our standard of care to prevent a reoccurrence includes annual ultrasounds to look for narrowing of blood vessels and regular red blood cell transfusions.