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What is Stroke?
A stroke is a brain injury caused by the interruption of blood flowing to part of the brain. Stroke can be caused by a blocked blood vessel in the brain or by a bleeding blood vessel in the brain.
Stroke in children has different causes than in adults. The most common cause of stroke in a child is a heart problem. Other causes for children include sickle cell disease (a type of blood disease passed down through families), infection, trauma, dehydration, blood clotting problems, and birth defects. In many cases, however, no cause can be found.
While strokes in children can be devastating, children appear to have a better ability to heal because of the greater flexibility and plasticity of their nervous system and brain. With physical‑and speech therapy, many childhood stroke survivors recover‑most or all the use of their arms, legs and speech.
Symptoms of stroke in children depend on the age of the child and the cause of the stroke. In newborns, the most common symptom is a seizure. Half of strokes that happen in the perinatal period are not recognized until infancy or later when the child shows early hand preference (e.g. before 12 months), or other delays in motor, language, or cognitive development. As easy way to recognize symptoms is to remember FAST:
Face: Ask the child to smile. Does one side of the face droop?
Arms: Ask child to raise both arms. Does one arm drift downward?
Speech: Ask child to repeat a simple sentence. Are the words slurred? Can child repeat the sentence correctly?
Time: If the child shows any of these symptoms, time is important Call 911 or get to the hospital quickly.
Any symptoms of stroke in children require an immediate trip to the emergency room. Diagnosis begins with a history and physical exam. During the history, the medical team may ask about any history of trauma, infection, delayed development, and about family history of bleeding problems. The physical exam will look for any signs of weakness, numbness, and other signs of stroke.
Several tests may be done to help make the diagnosis:
- Brain imaging studies. Special tests that make pictures of the brain called MRI, MRA, or CT scan are done to look for evidence of stroke in the brain.
- Blood tests. Blood is taken to look for signs of infection and blood clotting abnormalities.
- Heart studies and blood vessel studies. Heart rhythm is checked with an EKG and special pictures of the heart and blood vessels may be taken to look for abnormalities.
- Lumbar puncture. Fluid is taken from the spinal cord area to look for signs of bleeding in the brain.
It is important to call 911 at the first sign of stroke in children. In adults, treatment works best if it is started within three hours after a stroke occurs. Little is known about effectiveness of acute therapy in childhood stroke. The type of treatment used will depend on the cause of the stroke and age of the patient. Treatment may include:
- Giving fluids to avoid or reverse dehydration
- Giving oxygen
- Blood transfusions
- Treatment of heart conditions
- Giving medication to treat abnormal blood clotting
- Giving blood thinning medications