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A stroke is a brain injury caused by lack of blood flow in a brain artery. A stroke can result from abnormal blood clots, heart problems, changes in blood vessels or injury to blood vessels. Sometimes strokes lead to bleeding in the brain. Strokes can happen to people of any age. Strokes in children can be difficult to diagnose because other neurologic problems have similar symptoms.
There are two types of strokes, ischemic (iss-KEEM-ick) stroke and hemorrhagic (hem-or-AJ-ick) stroke. Either of these types of strokes results in brain injury.
Ischemic stroke can be caused by a blood clot or by abnormal blood flow. Blood clots can form in the heart or in blood vessels. If the clot travels to a blood vessel in the brain, it can block blood flow. This can lead to brain injury. It is important we determine the cause of an ischemic stroke so we can offer the appropriate treatment.
Hemorrhagic stroke is caused by injury to a blood vessel. Sometimes, when we see a hemorrhagic stroke, we find a blood vessel abnormality such as an aneurysm (AN-yer-izm).
It is important to know that different strokes can cause different signs and symptoms. When a child is having a stroke, you may see one or more of these signs come on suddenly:
A stroke is diagnosed by considering the child’s clinical history, neurological exam and the results of certain tests. Tests that may be done include CT scan (computed tomography). Usually, this test is done first because it is quick and readily available. The MRI (magnetic resonance imaging) is more sensitive to small changes in the brain and in blood vessels. It gives a better picture but takes more time, and in many cases, the child needs to be sedated. Both the CT scan and the MRI take a picture of the child’s brain.
MRA (magnetic resonance angiogram), CT angiography, MRV (magnetic resonance venography) and angiogram are tests that we use to look at the blood vessels in the brain. We perform different imaging tests, depending on the type of stroke and the child’s clinical history.
It can be difficult to figure out why a child had a stroke. However, it is important to try to find the cause so we can decide on an appropriate treatment and try to reduce the risk of future strokes.
Our multi-disciplinary stroke team includes pediatric specialists in the areas of Neurology, Hematology, Neuroradiology, Neuropsychology, Occupational Therapy, Physical Therapy, Speech Therapy and other medical specialists as needed. We will address all diagnostic and treatment issues relevant to your child’s care. When your child leaves the hospital, follow up in our Pediatric Stroke Clinic will be arranged.
Treatment depends on the causes of the stroke. Drugs that may be used include blood thinners and other medicines that prevent clots. In a few cases, surgery might be needed
Your child may need intensive therapy right after the stroke. When your child is stable, he or she might be transferred to the rehabilitation medicine service for further therapy. During rehabilitation, a combination of medicines and therapies will be used to help with recovery. If you have any questions, be sure to ask your child’s doctor or nurse.
Pediatric Stroke Network: www. Pediatricstrokenetwork.com
Children’s Hemiplegia and Stroke Association: www.chasa.org
Sickle Cell disease Association of America: www.sicklecelldisease.org
Strokes in Children (PDF)
HH-I-302 6/09 Copyright 2009, Nationwide Children’s Hospital