One look at the doctor’s face told Melody that there was something wrong. She and her husband were getting together all the balloons, cards and flowers in her hospital room in preparation for discharge in a few hours when he appeared. He told her that while she’d be going home on schedule, their newborn daughter had a congenital heart disorder and had just suffered a stroke.
Although most people associate strokes with the elderly or adult medical conditions like high blood pressure, they happen to around 6 of every 100,000 children each year, according to St. John’s Hospital in Springfield, IL. At least one third of the victims are newborns.
Up to 35 percent of infants who survive a stroke will have another one. Around two-thirds of them will suffer from cognitive deficits, physical disabilities or seizures.
Stroke is one of the top 10 causes of death in children, the hospital reports.
Two main types of strokes affect children, according to the American Stroke Association. An ischemic stroke is the result of an obstruction in a vessel that supplies blood to the brain. A hemorrhagic stroke occurs when a weakened blood vessel ruptures and bleeds into the brain.
Determining the cause of a stroke is essential to make sure a child gets the right treatment and to prevent additional injury. Doctors are able to pinpoint the cause in around two out of three cases. The Pediatric Stroke Network reports that among the causes of pediatric strokes are antiphospholipid antibody syndrome, in which the body erroneously produces antibodies against phospholipids, and arteriovenous malformation (AVM), a congenital disorder marked by a tangled web of arteries and veins.
Events during the birth process can also cause strokes. Other principal causes include blood and clotting disorders such as sickle cell anemia and disseminated intravascular coagulation, encephalitis and meningitis.
In adolescence, any type of illicit drug injected into the individual’s bloodstream can cause a stroke. Random blood clots that have broken loose from the original site of the blockage are sometimes the culprit.
A variety of genetic problems such as Moyama disease and Factor V Leiden have been identified as potential causes. Babies born at least three weeks prematurely are also at elevated risk for strokes.
Symptoms and effects
The medical team that delivers a newborn or oversees any required specialty care is usually the first to witness any signs of a stroke. In older children, it’s usually a caregiver unless the child is already hospitalized.
While most adults arrive at a hospital within 24 hours after the first signs of a stroke, the time jumps to between 48 and 72 hours for children. Among those old enough to communicate, a severe headache is often the first complaint.
Children experiencing strokes often complain of nausea, vomiting or both. Their skin might feel warm or clammy and look flushed. Other signs are a slow pulse, distended neck veins and speech difficulties.
Eye movement problems could include partial or complete blindness, blurred vision or pupils that appear unequal. Some children experience paralysis, weakness or balance problems, usually on one side of the body. Parents might note a facial droop or drooling.
Seizures are not uncommon in pediatric strokes. Some kids experience urinary incontinence and suffer a loss of consciousness briefly.
Generally, the effects of a stroke in children are similar to those an adult suffers. They include weakness or paralysis on just one side of the body, a tendency to ignore the weaker side, difficulty with speech and language and trouble swallowing. Also common are a decreased field of vision, mood swings and loss of emotional control, decreased cognitive ability and personality changes resulting in improper language or behavior.
Since the effects vary greatly from one patient to the next, doctors must customize treatment for strokes in children to each patient’s needs. Recovery is different for each child. Although most youngsters recover more abilities than older people do, the chance for the fullest recovery occurs after prompt treatment and rehabilitation therapy.
St. John’s Hospital site
American Stroke Association site
Pediatric Stroke Network site