Stroke in children follows patterns similar to adults and is much more common than previously suspected, according to two recent studies. Though we tend to associate stroke with older adults, it is not uncommon in children. In fact, it occurs in about 12 of every 100,000 children, and is one of the leading causes of childhood death. Stroke can happen in children of all ages, even while still in the womb. Although most children who suffer a stroke survive, they face life long disability and care needs.
Pediatric stroke usually occurs when a blood vessel in the brain breaks or a blood clot travels to one of the arteries in the brain. The result of either of these situations is that the brain is unable to receive blood and oxygen correctly, and begins to die. The amount of brain that dies is what determines if the child is able to survive the stroke. Dead brain never recovers, though a pediatric patient can recover some neurologic function through good brain taking over the function of damaged brain.
Pediatric strokes are generally not associated with the same risk factors as adult strokes. Some children may have a family history of blood diseases (coagulopathy) that give a clue to a child’s increased risk of stroke. A few other children may have a cardiac condition that is identified in childhood which places them at increased risk. Another common cause is arterial dissection from sports or roughhousing. In some instances, particularly intrapartum stroke, the cause is currently not well understood.
A recent study published by the Child Neurology Society shows that symptoms of acute ischemic stroke in children are similar to those in adults. Recognition of stroke follows the same “F.A.S.T.” protocol applicable to adults – 85% of children present with Facial drooping, Arm weakness and/or Slurred speech, meaning Time is of the essence to treat. Weakness on one side of the body occurred in 72% of the children. In addition, pediatric stroke can be marked by diffuse features like headache and decreased level of consciousness (61% of kids present with this feature) or seizures (found in 29% of children).
Treatment options vary, depending on the nature of the injury and the age of the child. Various treatments include anticoagulation, thrombolytics (“clot busters”), and balloon angioplasty. Some of these treatments are only available at major children’s hospitals. Unfortunately, a delay in diagnosis can cost the child critical time and all of these treatments are time sensitive. A delay in treatment can form the basis of medical negligence (medical malpractice) claim under Ohio law.
