A stroke is a sudden loss of oxygenated blood to the brain caused by a blockage or break of blood vessels in the brain. A pediatric stroke is most common during the first year of life, with perinatal strokes happening in 1 in 4,000 births. A serious and often life-threatening condition, it has lasting effects even when the life-threatening stage has passed, because the loss of oxygen and other nutrients will cause brain tissue damage after only a few minutes. A stroke may be small and localized or it may cause widespread damage.
Strokes are treated according to their cause and type. Hemorrhagic strokes are caused by broken arteries that deliver oxygenated blood to the brain. This brain bleeding deprives brain tissue of oxygen and other nutrients and may also increase pressure within the brain. Surgery may be needed to alleviate pressure. Ischemic stroke is caused by the blockage or narrowing of an artery. These strokes are sometimes difficult to treat in children because it is unknown whether some clot-busting drugs are either inappropriate or unsafe for use in young children. The third kind of stroke is known as a TIA (for transient ischemic attack) and is a kind of mini-stroke. Mini-strokes may go unrecognized in very young children, with signs only becoming apparent after many have occurred.
Because stroke in young children is rare, parents and medical providers may not catch the signs and symptoms at first. In young children, signs of stroke include:
- Sudden confusion or disorientation without apparent cause
- Slurred speech
- A droopiness on one side of the face
- A sudden loss of sight or double vision in one eye
- A sudden weakness, loss of sensation or inability to move one side of the body
- A sudden loss of balance
- A severe headache accompanied by vomiting or double vision
In infants or while still inside the womb, it's even more difficult to see signs of a stroke, and it may only be recognized months afterward. In infants, seizures, extreme sleepiness, and using only one side of the body may be signs of a stroke.
Stroke is diagnosed by a number of neurologic exams, medical imaging, and blood tests. It is important to understand the underlying cause of strokes in children. In infants and children, possible causes may include pregnancy-related maternal high blood pressure, abnormal blood vessels in the brain, head or neck trauma, abnormal blood clotting, sickle-cell disease, immune disorders and certain congenital heart or metabolic conditions.