Dr P.N. Renjen, Senior Consultant, Neurology, Indraprastha Apollo Hospitals
Stroke is a brain injury which is caused by the interruption of blood flow to parts of the brain. It can be caused by bleeding in the brain or it can be caused by a blocked blood vessel. If a blood vessel in the brain is injured, the brain tissue around it also loses its blood supply and suffers injury as well. Stroke in children is a rare condition. The risk of stroke is highest in children before age one. It is considered as one of the main risk factors in children. In children, without prompt and appropriate treatment, it can be life-threatening and therefore requires immediate medical attention.
There are mainly two types of strokes i.e Hemorrhagic and Ischemic. Hemorrhagic stroke occurs when a blood vessel in the brain ruptures leading to flooding of blood in the brain and damaging the brain cells. While in Ischemic stroke blood supply to the brain got blocked. This leads to low oxygen levels in the brain and brain cells die. Strokes block blood flow and can cause bleeding in the brain and can occur at any age. Strokes are more common in children, but they can occur in children of any age, not just premature babies. In babies, blood clots in older children can cause a stroke within a week of birth. Strokes in children usually occur between the 28th week of pregnancy (when a child is born) and one month after birth.
Causes
The general causes of stroke in adults are hypertension, diabetes, or atherosclerosis. While in children it is hard to find out the exact cause. The risk factors in children are more varied. The common causing factors can be:
- Lack of oxygen supply to newborn during birth
- A heart defect in a newborn baby
- Blood disorders such as sickle cell disease, which destroys blood cells and block blood vessels
- An injury to an artery
- Dehydration
- Genetic disorders
- An infection such as meningitis or chickenpox
- A head injury during the birth
- An aneurysm
- Disease that affect blood clotting
Other than that the problems that affects a mother during pregnancy can also be a causing factor such as:
- High blood pressure during pregnancy that causes swelling in feet, hand and legs
- Premature rupture of membranes
- Diabetes
- Infections
- Drug Abuse
- Placenta problems that decreases the baby’s oxygen supply
Signs and Symptoms
Many of the symptoms of stroke in children are similar to those in adults. This can include sudden weakness, slurred speech and blurred vision. The symptoms of stroke in children depend on the age of the child and the cause of the stroke. Children and new-borns can have a stroke with additional or other symptoms such as:
- Seizures in one area of the body, such as arm or leg
- Problem in eating or swallowing
- Trouble in breathing
- Early preference of using one hand over the other
- Developmental delays in infants like delay crawling or walking
- Headaches without vomiting
- Memory loss
- Sudden mood or behaviour change
For some children, the first symptoms of a stroke are the first warning and there is no way to prevent them. Only the doctor can treat the conditions that lead to the first signs of stroke.
Diagnosis and Treatment
If a child does not have any clear symptoms, it’s hard to diagnose stroke. It can only be diagnosed if a child has symptoms like seizures or developmental delays. If a stroke is suspected then the doctor will have further investigations done for the treatment. In a child, who has an ischemic hemorrhagic stroke may need emergency surgery to reduce the pressure in the brain. Once the child has recovered, doctors will focus on identifying and treating conditions that may have caused a stroke.
Therefore, for parents it is very necessary to keep in notice the first symptoms of stroke as it can lead to early diagnosis and treatment.