Pediatric Stroke

Most individuals think of stroke as a concern for older adults. Stroke or cerebral vascular accident (CVA) can occur at any age, including pre-birth through the teen and young adult years. It can occur in the brain, spinal cord, or both. Stroke in children creates unique challenges, especially in societal responses to a situation unfamiliar to many.

In the brain, the location of the stroke will affect body function. Typically, a stroke in the brain affects function on one side of the body, but it can also affect speaking, thinking, reading, and seeing. In the spinal cord, movement and sensation can be affected below and above the location of the stroke. Stroke syndromes can occur when function may be lost in the arms but not the legs, or in sensation on one side of the body but loss of function on the other side. A stroke in the brain or spinal cord can affect coordination.

The cause of stroke in children is due to blood flow issues. This includes ischemia (too little blood flow) as from a blocked artery or hemorrhage (bleeding) artery rupture, which puts pressure on surrounding delicate nerve tissue.

Some health issues that can lead to stroke in the brain or spinal cord are:

• Heart function or structural issues
• Sickle cell disease and other clotting or metabolic disorders
• Aneurysms or ArterioVenous Malformations (AVM) (misconnections between the arteries and veins)
• Major infections such as meningitis or encephalitis
• Injuries to the head or spine from medical issues, accidents (falls, sports, automobile), or abuse
• Dehydration
• Migraine headache
• Multisystem Inflammatory Syndrome (inflammation of body organs)
• Lack of oxygen at birth or due to disease or injury
  
  

Symptoms of stroke in young children may include seizures, sleepiness, change in mental status, a tendency to use just one side of the body, or lack of movement in the lower body. In older children, symptoms are more like in adults. Some children may have a single stroke, while others may have several, depending on their healthcare issues. Controlling the cause of the first stroke, through surgical intervention or medical treatment of health issues helps prevent a second stroke.

The treatment for stroke is based on the issues particular to the child. The first measures to be taken are to stabilize the child. This includes ensuring the child has oxygen and the circulatory system is functioning. Treatment for an ischemic stroke includes dissolving the clot so blood can flow throughout the body. A hemorrhage may be surgically treated to stop blood from flowing outside of its normal route. An AVM may need to be surgically or medically reduced. Hydration of the body, antibiotics for infection, and control of medical issues should be provided.

Long-term therapy may be needed to improve function. This includes speech and language therapy for the enhancement of speaking, reading, and thinking. Physical and occupational therapy can assist with the improvement of movement and function. Phycological interventions can be provided to assist with impulse control and behavior. Family counseling assists with mental wellness for the entire family through life transitions.