Stroke in Children: What Families Need to Know

Posted on May 11, 2016

Most people may think of stroke as a disease affecting older adults, but infants and children can also experience a stroke. In fact, the American Heart Association reports that stroke affects 6 out of every 100,000 children, aged 0-15.

A stroke is an injury to the brain caused by reduced or blocked blood flow in one of the arteries that supply oxygen-rich blood to the brain. Sometimes a stroke can occur when there is a clot in the arteries of the brain or neck. When blood doesn’t flow properly to the brain it affects parts of the body in different ways. Some symptoms of stroke in children can include:

  • Sudden/severe headaches (vomiting or feeling tired may accompany a headache)
  • Weakness on one side of body
  • Difficulty speaking or understanding
  • Vision loss/double vision
  • Dizziness
  • Seizures on one side of body
In addition to the symptoms above, the acronym “F.A.S.T.” is a quick way to remember signs of a stroke:

F – face drooping

A – arm weakness

S – speech difficulty

T – time to call 911

Types of Stroke

While stroke in children is rare, the disease can have serious effects on a child’s health. Pediatric strokes can occur before an infant is born or later in life depending on a child’s risk factors. Types of pediatric strokes include:

  • Perinatal Stroke (Birth – less than 1 month old)
    • Many families aren’t aware that stroke in newborns is the most common form of pediatric stroke, occurring around the time of birth. It’s also the most common time for a stroke to occur prior to middle-age adulthood. Expectant mothers with preeclampsia, a history of infertility or an infection in the fluid surrounding the baby, may be at a higher risk of having a baby affected by stroke. While diagnosis of a stroke in an infant may be hard to detect, families and health care providers should watch for twitching or decreased movement in one side of the body or pauses in breathing (apnea).
  • Stroke in Children (1 month – less than 18 years old)
    • Stroke in older children may be less common than perinatal strokes, though there are certain groups of children that are at a higher risk. Congenital heart disease, some types of cancer, autoimmune disorders, sickle cell, blood disorders, as well as infections affecting the brain or other organs are all risk factors of pediatric stroke. 

Treatment and Research

Pediatric stroke is a complex disease so it’s important to choose a physician or team with extensive experience in treating stroke to help prevent possible short-term and long-term complications. Some complications could include:

  • Bleeding complications from aspirin or blood thinners
  • Development of a second stroke
  • Neurological effects such as:
    • weakness
    • difficulty walking
    • loss of coordination
    • problems speaking
    • learning difficulties
    • difficulty with attention
    • disruptive behavior
    • depression/anxiety
    • seizures 

Early diagnosis is key in treating pediatric stroke and treatment could include surgery or medication. Optimal treatment would involve a highly experienced team of experts specializing in stroke, which includes a pediatric stroke neurologist, pediatric stroke hematologist and other specialists:

  • pediatric emergency department physicians
  • pediatric radiologists
  • pediatric anesthesiologists
  • pediatric and neonatal intensive care physicians
  • pediatric neuropsychologists/psychologists
  • pediatric pharmacists
  • pediatric rehabilitation physicians and therapists 

In order to better understand the best treatment for the various types of stroke in children, Johns Hopkins All Children’s Hospital in St. Petersburg, Florida and the Johns Hopkins Children’s Center in Baltimore, Maryland, established a collaborative stroke program to help children receive the highest quality care at each location. They also work together and with other experts around the world to study new ways to treat stroke patients to achieve the best possible outcomes.
Learn more about the Stroke program at Johns Hopkins All Children’s Hospital

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