Pediatric Stroke and Awareness guide

A stroke happens when blood that carries oxygen and nutrients stops flowing to part of the brain. Without a steady supply of blood, brain cells in the area begin to die within seconds. This can lead to stroke symptoms and sometimes to lasting neurologic deficits or sadly, death.

While most have heard of stroke in adults, Pediatric stroke causes can and does happen at any age. Stroke can happen in newborns, children, teens, and even around the time of birth. Stroke in children is often different from adult strokes, with different causes and sometimes different symptoms and treatments.

A stroke is a medical emergency. If you think a child is having a stroke, call 911. A rapid response, quick diagnosis, and treatment for your child may help limit damage to the brain.

Age vise Pediatric Stroke category

• Perinatal, which refers to the last 18 weeks of gestation through the first 30 days after birth. Other terms for this include fetal, prenatal, in utero for the period before birth. Neonatal and newborn for birth through one month of age. Estimates reflect that perinatal stroke occurs in approximately 1 out of every 2000 live births. With the risk of stroke from age 1 month to 19 years, being 5 per 100,000 children.

• Childhood, In this category children ages, have between 1 month to 18 years.

Types of Pediatric Stroke

There are two main types of stroke that occur at any age: ischemic stroke and hemorrhagic stroke.

• Ischemic stroke: A pediatric ischemic stroke that occurs when an artery that supplies blood to an area of the brain narrows or becomes blocked. This results in a decreased amount of blood reaching the area of the brain beyond the blockage, resulting in brain damage.

• Hemorrhagic stroke: A stroke caused by the breakage of a blood vessel within the brain that often causes damage to the brain tissue.

“More research is needed to better understand the exact timing and causes of perinatal strokes to determine the most effective treatment and prevention strategies and to support long-term recovery to maximize outcomes for the child.”

Dr. Adam Kirton
Pediatric Neurologist, Calgary

The symptom of Pediatric Stroke

Perinatal Stroke Symptom: Symptoms of stroke tend to be different in newborns (age 28 days or younger) than in older children. Seizures are a common symptom of perinatal stroke in children. They usually start 12 to 48 hours after birth and repeat.

Some babies have no clear symptoms for weeks or months after their stroke. Often parents, caregivers, and doctors do not notice any signs of perinatal stroke until age 4 to 6 months when the baby starts to seem weaker or partly paralyzed on one side of the body (hemiplegia or hemiparesis). Pediatric stroke at birth

Childhood Stroke Symptoms: Children who have a stroke tend to have 1 or more of these symptoms that come on suddenly:

• Sudden weakness, paralysis or numbness in the face, arm, or leg, usually on one side of the body.
• Sudden confusion, trouble speaking, understanding language.
• Sudden changes in vision, such as decreased vision or double vision.
• Sudden dizziness, loss of balance, or loss of ability to stand or walk.
• Sudden, severe headache with or without vomiting and sleepiness.
• Seizures in a child who has not had seizures before. (usually on one side of the body)

Key Points of Pediatric Stroke Awareness

perinatal Strokes Key Point

• The majority of Pediatric Strokes in children occur in the Perinatal period affecting roughly 1 in 2000 live births.
• The most common type of stroke in the perinatal period is ischemic stroke.
• Less than 1% of children who have had Perinatal stroke will go on to have more strokes.
• A stroke before birth may be called fetal, prenatal or in-utero
• A stroke just before birth may be called neonatal or newborn
• In most cases of Perinatal stroke, a cause cannot be determined.
• Perinatal strokes in newborns are often missed because the signs and symptoms are subtle. Many infants do not show any signs of stroke until they are 4 to 6 months old.
• Infants with early hand preference before 12 months should see their pediatrician and request a referral to a pediatric neurologist to rule out anything neurological.

Childhood Strokes Key Point

• Childhood Strokes maybe missed because there is a lack of awareness that children can indeed have a stroke. However, the risk of stroke from birth through age 19 is nearly 5 per 100,000 children per year.
• Many children with stroke symptoms are misdiagnosed with the more common conditions that stroke mimics such as migraines, epilepsy, or viral illnesses.
• In older children, the signs and symptoms of a stroke are very similar to those in adults and depend upon the area of the brain involved.
• The use of tPA (a clot-busting treatment) is not currently FDA approved for children in the US. Time is Brain! Early recognition and treatment during the first hours and days after a stroke are highly critical in optimizing long-term functional outcomes and minimizing recurrence risk.

Treatment of Pediatric Stroke

• If symptoms of pediatric stroke seizure are seen, the infant should be taken to the hospital immediately for assessment, diagnosis, and treatment.

• Treatment for perinatal stroke usually does not include administering blood thinner medications (called antiplatelets or anticoagulants) to reduce further clots from forming. However, if the stroke is due to congenital heart disease or a serious blood-clotting disorder, sometimes these medications are needed.

• Medications and other treatments may be recommended to help treat the symptoms (e.g. to control seizures) or correct the cause of the stroke, such as rehydration, antibiotics for meningitis, and, medication or surgery to correct heart abnormalities.

• Pediatric Stroke Rehabilitation is generally believed to improve outcomes over the long-term.

Growing Up After A Pediatric Stroke Recovery And Moving Forward
Family Roles

Every family member plays an important role in a child’s recovery from Pediatric stroke. Family members can do many normal activities to help a child recover. It is important that family members and care providers gain as much education and understanding of stroke as possible.

Here are some things that families can do together:

• Create an enriching environment. Read Stories, do a puzzle or a craft.
• Do activities together that need two hands! Try shaping cookies from cookie dough and gradually work up to more challenging tasks.
• Share in lots of laughs! Positive emotions and laughter help prepare the brain to be ready to learn.
• Play a video game (but be careful if seizures are a problem for the child).
• Go on outings together.

Read Stories of Padiatric Stroke Survivor Click here

“Keep all your records organized and available. Once you get yourself organized, you’ll feel more in control and less overwhelmed. Prepare a package of important information to provide everyone who will be working with your child (such as, teachers, healthcare workers, and coaches).”

Cortney,
Mom of Brookelyn, Calgary

Pediatric Stroke Physical Therapy

Early intervention programs provide specialized health, educational, and therapeutic services during the first three years of life for children who have developmental delays or disabilities.

Children who are considered “at-risk” of developing a delay may also receive services. The most common intervention services for children after stroke are physical therapy, speech and language therapy, and occupational therapy. These services are mandated by a federal law called the Individuals with Disabilities Education Act (IDEA). The law requires that all states provide early intervention services for any child who qualifies, with the goal of enhancing the development of infants and toddlers.

Intervention is vital during this very early time after stroke because a child learns and develops at the fastest rate during these first few years. It’s important not to miss out on this crucial part of your child’s development.

The goal is always to help your child achieve the highest function and interaction at home and in the community. Early intervention can also be a huge support and guidance to your family. There is a lot to know about early intervention, we have covered the basics to help as you get started.

How Does Pediatric Stroke Differ From Adults Stroke?

Stroke can affect children and adults of any age. The causes of stroke in children are different from adults. Symptoms of stroke in newborns and pre-school children are often different from adults because a child’s brain is still developing. However, in older children, the signs and symptoms of a stroke are very similar to those in adults and depend upon the area of the brain involved. For newborns and children, the diagnosis is often delayed or missed because usually, you would not think of a stroke as the first explanation for the symptoms.

“This isn’t what I expected for my firstborn but Zach is so beautiful and teaches us so many things all the time, we couldn’t imagine him any other way!”

Charlene
Mother of Zachary, Winnipeg

Which Month Is Pediatric Stroke Awareness Month?

May is Pediatric Stroke Awareness Month

PEDIATRIC STROKE SUPPORT GROUPS ON FACEBOOK

1. CHASA Hemiplegia Parent Support– National Facebook Group
2. KISS Pediatric Stroke Support Group – National Facebook Group
3. Little Stroke Warriors Support Group – (Australia and New Zealand) Facebook Group
4. (MISS) Moms of Infant Stroke Survivors—National Facebook Group
5. Pediatric Stroke Warriors of the Inland Northwest (Idaho & Spokane) Facebook Group
6. Pediatric Stroke Warriors family to family (Greater Pacific Northwest Region) Facebook Group
7. Pediatric Stroke Support Group of Colorado—(Rocky Mountain Region) Facebook

PEDIATRIC STROKE ORGANIZATIONS

Pediatric Stroke Warriors continue to strengthen communities through support, advocacy, and education. However, it is just as important for families to know of the many other Organizations dedicated to making a difference for Pediatric Stroke.

American Heart/American Stroke Association: visit Site
Bellaflies Foundation: Visit Site
Canadian Pediatric Stroke Support Association: Visit Site
CHASA: Visit Site
Children’s Stroke Foundation of the Midwest: Visit Site
Fight The Stroke: Visit Site
World Pediatric Stroke Association: Visit Site