When a child has a stroke
One of the top 10 killers of children, but almost unknown and undiscussed, here’s what to look out for when it comes to strokes and children.
A stroke is generally associated with being old and it is simply not something that a parent thinks can ever affect their child. However, strokes do affect children and according to an article titled Paediatric Stroke Treatment Comes of Age, written by Dr Michael Morgan Dowling, they are as common as childhood leukaemia.

‘Stroke is one of the top 10 killers of children,’ says Dr Dowling, ‘… and yet until recently there were no clinical guidelines, systematic research programs, or randomised clinical trials for stroke intervention or prevention in children.’

What happens when a baby or child has a stroke?

Pretoria-based paediatrician Dr Johani Vermeulen explains: ‘A stroke results in a rapid loss of brain function due to a disturbance in the blood supply to the brain. It can either be caused by a blocked blood vessel, called an ischaemia, or burst blood vessel, called a haemorrhage.’

The signs and symptoms of a stroke

According to the US-based Children’s Hemiplegia and Stroke Foundation, symptoms differ according to the age of the baby or child.

•    In a small baby, symptoms include poor feeding, clear hand preference before the age of 10 months or seizures that are confined to just one area of the body.
•    In young children, symptoms include delays in gross motor development or speech, and restricted or tight movement of the limbs.
•    In older children, symptoms include seizures, sudden paralysis on one side, loss of speech or balance, and visual disturbances.

What is the prognosis?

While a stroke itself is the same no matter what the age of the patient, the damage that it is able to do is heavily dependent on the age and developmental level of the baby or child at the time of the injury. An adult whose brain is fully developed, can be given a clearer prognosis than a child whose brain is still rapidly developing.

‘A stroke in a baby or child can be totally debilitating or have no long-term effect whatsoever,’ says Dr Vermeulen. This is because the developing brain has an amazing ability to repair itself and rebuild neural networks that may have been damaged.

How common is it?

Strokes are more common in babies under the age of 28 days, occurring in 1 out of 1500 babies.  Older babies have less chance, with the occurrence being 1 out of 12 500 – 16 500 children. It also appears from research that boys are more at risk, the reasons for which are not presently clear, says Dr Vermeulen.

Ask three little questions

If you suspect a child or any person has suffered a stroke, the American Stroke Association urges everyone to remember three simple questions. If the person cannot follow these instructions they need urgent medical assistance.

1.  Ask the person to smile.
2.  Ask the person to raise both arms in front of them and keep them up.
3.  Ask the person to speak a simple sentence coherently.

Where can you find support?

Unfortunately there are no support groups or organisations within South Africa that deal specifically with paediatric stroke, however, there is a large online community and valuable information available through the US Childhood Hemiplegic and Stroke Association (CHASA).

Within South Africa, children who suffer brain damage as a result of a stroke are often included in the Cerebral Palsy community, despite the fact that the conditions are not the same, but the resulting physical and cognitive challenges may be similar. Contact the United Cerebral Palsy Association to find out more about support in your area.

Has any member of your family had a stroke?

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