Stroke in children: what you need to know about it as a parent?
If you're a good parent you should give more attention to your child's health.
Stroke is a pathology of the brain of vascular origin which can affect both children and adults. It can have serious health consequences.
Stroke is an acute cerebrovascular disease that can occur in the womb of the mother, during childhood, or in adulthood. In children, the factors that can trigger it are varied, among which heart and hematological diseases stand out.
During childhood, the incidence of stroke is low but its future neurological consequences are of great importance. Depending on the area of the brain that is damaged, it can lead to cognitive deficits, neuron muscular problems, or speech disorders, among others. In this article, we will tell you everything about this disease, how it manifests itself, and its long-term consequences. Don't miss it!
What is stroke in children?
Stroke is an acute disease in which blood flow to the brain is interrupted, either by occlusion or rupture of a blood vessel. It is also known as a cerebrovascular accident ( CVA ) and, by definition, it affects the functioning of the brain due to a stoppage of the blood supply to the tissues for a long period.
We speak of pediatric stroke when the episode occurs from the perinatal stage until the age of 18. Neonatal strokes and those occurring during the first year of life are the most common and are usually quite severe. Of the total number of child victims of a stroke, 70% develop subsequent sequel, 20% recur with a new episode and between 6 and 10% die.
Certainly, although the greatest number of cases of stroke occur in adults, the prevalence in children has increased in recent years. Thus, it is estimated that there are between 1.8 and 13 cases per 100,000 children per year and this places it among the top 10 causes of death in children.
Types of stroke
The brain is a very irrigated organ and consumes about 20 to 25% of the total blood circulating in the body (volume). Indeed, its nutrient and oxygen need to fulfill all its functions is high. When cerebral irrigation is interrupted, a stroke appears, which, depending on its nature, can be divided into two types:
1. Ischemic: following an obstruction of a vein or an artery by a thrombus or an embolism, which prevents the blood from reaching a part of the brain. Consequently, the affected tissue does not receive oxygen or nutrients, and after a few minutes, it is damaged or dies.
2. Hemorrhagic: it occurs when there is a rupture of a blood vessel in the brain or in the tissues that surround it. This causes hemorrhage into the cavity, making it difficult to properly irrigate cells distal to the lesion.
Causes of stroke
The main causes of stroke in children are very varied, depending on whether it is an ischemic or hemorrhagic stroke.
- Ischemic strokes
- Central nervous system infections, such as meningitis and encephalitis.
- Head and neck injuries.
- Surgeries.
- Congenital heart disease.
- Arteriopathies
- Blood disorders, such as sickle cell anemia and clotting problems.
- Congenital errors of metabolism.
- Hemorrhagic strokes
- Intracranial tumors.
- Congenital malformations of blood vessels.
- Hematological diseases.
It should be noted that there is a percentage of strokes of unknown cause. When it occurs in the uterus or the perinatal period, the causes derive from congenital malformations, infections, or other maternal diseases, such as autoimmune diseases or preeclampsia.
Stroke symptoms in children
Like any acute disease, the stroke must be diagnosed as soon as possible to avoid further sequel. However, parents' lack of knowledge of the typical manifestations of this disorder delays medical evaluation. Primarily, caregivers should note changes in the child's behavior, body movements, and speech.
In babies under 5 months, the diagnosis is even more complicated but it can be suspected when some of the following symptoms appear:
- Facial spasms or dystonia.
- Lack of mobility in a part of the body (hemispheres).
- Seizures.
- Apneas.
In older children, symptoms are rated on the same scale used in adults (called FAST, for face-arm-speech-time ):
- Face (face): frozen face.
- Arm (arm): weak arm.
- Word (speech): difficulty speaking.
- Time (time): time to get to the emergency room as quickly as possible.
In addition, other sudden acute symptoms may be observed:
- Vomiting.
- Intense headaches.
- Lack of coordination of body movements.
- Muscle weakness on one side of the body.
- Loss of balance.
- Vision problems.
- Disorders in the sensitivity of the face and extremities on one side of the body.
- Speech difficulties.
How is a pediatric stroke diagnosed?
The way to diagnose a stroke with certainty is to perform additional tests, such as an MRI or CT scan of the brain. Thanks to these examinations, it is possible to identify the place where the injury occurred and to estimate its severity, to quickly initiate the appropriate treatment and the necessary rehabilitation. Other complementary tests that the specialist may indicate are the following:
Blood tests.
Echocardiogram and other studies of the heart.
Imaging studies to assess cerebral blood supply.
Treatment
The treatment of stroke in children depends on its nature (ischemic or hemorrhagic), the degree of tissue damage, and the damaged area of the brain. Rehabilitation helps reverse the neurological sequelae that result from ischemia or intracranial hemorrhage.
Greater recovery of neurological functions was observed in children with stroke, compared to adults. Indeed, their brain has great neuronal plasticity, which allows greater repair and adaptation of their tissues. In a stroke, physiotherapy (for the recovery of body mobility), occupational therapy, and speech therapy are necessary.
Consequences in the child
Strokes can be fatal in children, depending on the severity of the injury and the area of the brain affected. In other cases, children may survive and develop long-term or medium-term sequelae, such as:
Hemispheres.
- Behavioral issues.
- Seizures.
- Physical and nutritional damage.
- Alteration of emotions and problem-solving.
- Cognitive and language deficits.
- Movement disorders.
The list of stroke sequel is long. However, rehabilitation based on physiotherapy and speech therapy helps the child regain his abilities. For example, it helps to improve the mobility of his limbs and his speech. Of course, everything depends on acquired brain damage, rapid intervention, and continuity of rehabilitation.
Acting quickly is essential
As we have seen, stroke is a rare but important cerebrovascular disorder in children who suffer from it. The main thing is to know its nature and ways to detect it early so that it can be treated quickly and effectively by health personnel.
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