Thankfully, stroke in children is rare. Its rarity, however, is part of what makes it hard to diagnose.
In adults, stroke occurs much more often, and therefore is easier to spot. People are told to look for three key signs, “FAST”: Face drooping, Arm weakness and Speech difficulties mean it’s Time to call 9-1-1. Furthermore, the key health conditions that put adults at risk for stroke are often already known (such as diabetes, high blood pressure and obesity).
In children and teens, however, stroke shares symptoms with many health problems that occur far more commonly. Some symptoms in young infants differ from those in adults. It can be hard for children to tell an adult exactly what they’re feeling. And because it is so rare, it is difficult for parents and doctors to suspect stroke right away.
Stroke Symptoms in Children
Any one of these signs by itself can be non-specific and may not be a sign of a stroke. When these signs suddenly occur in some combination, the suspicion for stroke is much greater:
Headache, with or without vomiting
Sudden weakness or inability to move on one side of the body
Sudden avoiding use of one arm, hand or leg, or using limbs as if it’s difficult to move normally
Sudden slurring of speech
Sudden weakness or drooping of the face
Sudden trouble swallowing
Sudden numbness or difficulty feeling things on one side of the body
Sudden trouble understanding when other people speak, or trouble following instructions
Sudden changes in vision, such as blurry or double vision
Signs of stroke in babies (especially when the signs suddenly appear together) may include:
Seizures (these don’t always affect the whole body—maybe just an arm or leg)
Sudden use of only one side of the body, or strong preference for one side
If you suspect your child is having a stroke, call 9-1-1 and say so, or take your child to an emergency room.
Is Your Child at Risk for Stroke?
Children can have many risks for stroke, including:
Heart conditions, such as uncorrected congenital heart defects, cardiac rhabdomyoma, rheumatic heart disease, cardiomyopathy or myocarditis, prosthetic heart valves, infectious endocarditis and others
Trauma, especially in kids with injury to the arteries from car accidents,
Blood vessel problems, such as those due to Down’s syndrome, neurofibromatosis, fibromuscular dysplasia, intracranial aneurysms, problems with the arteries or their formation, or other problems with blood flow
Inflammation of the veins, caused by infections, lupus, AIDS, drug abuse, Behcet disease, meningitis, Chicken pox or other infections
Blood clotting problems, caused by things such as excessive clotting (thrombophilia), cancer, birth control, kidney problems, inflammatory bowel disease and others
Genetic/Metabolic conditions, such as sickle cell disease, mitochondrial diseases and nuclear disorders, hyperhomocysteinemia,Fabry disease, and others
Other health problems, such as severe iron deficiency, hemoglobin disorders, migraines, severe blood pressure problems,
Protecting Your Child
If your child shows signs of a stroke, you can expect numerous tests at the hospital to find the cause. These may include blood tests, imaging, heart studies, questions and tests to check their mental function and more.
Some steps you can take to help your child include:
Call 9-1-1 right away if your child shows signs of stroke — every second counts.
Get your child vaccinated — studies show that infections, including chicken pox, increase the risk of stroke in children.
Follow treatment plans closely if your child has a chronic disease or any problem with the heart, brain, blood vessels, metabolism or other body systems.
Know your family health history, so that you can help doctors find the most likely cause of your child’s symptoms, as well as the right treatment.
Warren D. Lo, MD, is attending pediatric neurologist at Nationwide Children's and Clinical Professor of Pediatrics and Neurology at The Ohio State University College of Medicine. His clinical and research interests center on stroke in infants and children. This emphasis led to the development of the Stroke and Vascular Anomalies Clinic at Nationwide Children's, where he serves as director.
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