Overview
A stroke, or “brain attack,” occurs when the blood supply to part of the brain is cut off, resulting in tissue injury and loss of brain function. When brain tissue is cut off from its supply of oxygen and nutrients for more than three minutes, it begins to die.
View the Pediatric Stroke Fact Sheet
There are two types of stroke:
- In ischemic strokes, brain arteries become blocked by a clot and prevent blood and oxygen from nourishing a region of the brain. A clot may form inside an artery if the artery is injured or narrowed, or if a problem exists with blood clotting (a so-called hypercoagulable state). Or, a clot may travel from a distant site (embolic clot). The most common distant sites include the heart and the neck vessels.
- In hemorrhagic strokes, brain arteries rupture from damage/trauma or malformation of the blood vessels. Blood accumulates inside the brain, causing pressure that leads to impaired flow of blood, oxygen and nutrients to the affected region, resulting in brain cell death. The risk of hemorrhage is higher with certain bleeding disorders, such as hemophilia.
Causes of stroke in children
The causes of stroke differ greatly in children and adults. Adult risk factors such as hardening of the arteries (atherosclerosis), high blood pressure, high cholesterol and diabetes do not commonly cause stroke in children. Rather, pediatric strokes may be caused by:
- Birth defects
- Infections (e.g., meningitis, encephalitis)
- Trauma
- Blood disorders, such as sickle cell disease or clotting problems
- Congenital or acquired heart disease
- Abnormalities of blood vessels (e.g. moyamoya, dissection, vasculitis)
- Metabolic disorders
Symptoms
- Sudden onset of severe, progressive headache
- Eye movement problems or complete or partial loss of vision
- Sudden numbness or weakness in the face, arm or leg (especially on one side of the body)
- Difficulty speaking or understanding words or simple sentences
Difficulty swallowing
- Dizziness, loss of balance or lack of coordination
- Brief loss of consciousness, seizures
- Sudden inability to move part of the body (paralysis)
Specific symptoms depend on the function of the part of the brain deprived of blood during the stroke. Some symptoms mimic those associated with adult stroke, while others such as seizure, nausea and vomiting are more common in children.
Every minute brain cells are deprived of oxygen during a stroke, brain damage increases. The chances of survival and recovery improve when treatment begins within the first few hours of stroke warning signs. Immediate treatment of a stroke may limit or even prevent brain damage. Hence, it is critical to get to the hospital quickly if you recognize stroke symptoms. The fastest and safest way is to call 911.
Treatment
The Pediatric Cerebrovascular Disorders Program offers advanced imaging, comprehensive diagnostic and therapeutic interventions for all forms of neonatal and childhood stroke including:
- Stroke associated with cardiac disease of interventions
- Vasculopathy of neurofibromatosis
Children with acute stroke are cared for in a Pediatric Intensive Care Unit staffed full-time by experienced pediatric intensivists in conjunction with our pediatric neurologists.
Our Pediatric Neurology team is a member of the International Pediatric Stroke Study Consortium, a group of international child neurologists, hematologists and rheumatologists from over 6 countries with a special expertise and interest in childhood stroke. The pediatric stroke team is also a founding member of the Ohio Pediatric Stroke Consortium which has established a pediatric stroke registry in Ohio.
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