Pediatric stroke refers to stroke in children between 29 days and 18 years of age. Pediatric stroke may be ischemic, in which a blood clot stops blood and oxygen from reaching the brain, or hemorrhagic, which involves a blood vessel rupturing.

Pediatric stroke is among the top 10 causes of childhood mortality and affects 2.3 to 13 children per 100,000 each year.

Due to a lack of awareness, people often miss the signs of stroke in children.

This article looks at symptoms of pediatric stroke and the steps a parent or caregiver should take upon noticing them. It also looks at types of pediatric stroke, their causes and risk factors, how they are diagnosed and treated, and a person’s outlook.

Lastly, the article examines the potential complications and prevention methods.

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Symptoms of a pediatric stroke may present differently than those of a stroke in adults. Symptoms may also present differently in older children than in newborns and infants.

The American Stroke Association states that symptoms of stroke in children include:

  • facial drooping
  • arm weakness
  • speech difficulty
  • sudden and severe headache, alongside sleepiness and vomiting
  • sudden numbness and weakness on one side of the body
  • sudden confusion
  • difficulty understanding others or speaking
  • difficulty seeing in one or both eyes
  • seizures, typically on one side of the body

In children and teenagers

In children and teenagers, common symptoms include focal deficits. Focal deficits are problems with brain function, nerves, and the spinal cord and may present as:

  • problems speaking
  • problems understanding speech
  • vision problems
  • hearing problems
  • paralysis or weakness in a specific area
  • loss of muscle control or muscle tone
  • involuntary movements
  • abnormal sensations
  • numbness
  • drooping on one side of the face
  • loss of coordination
  • changes in mood and behavior

Other symptoms include:

In newborns and infants

The most common symptom in newborn children and infants is a seizure.

Other common symptoms include:

  • fatigue
  • poor feeding
  • nausea and vomiting
  • fever
  • cardiopulmonary dysfunction
  • headache

If someone notices the symptoms of a stroke in an infant or child, it is important to seek emergency medical attention as quickly as possible.

Treatments for stroke are most effective when a person receives care soon after their first symptoms, and faster care can minimize damage to the brain.

Pediatric stroke falls into two categories — ischemic or hemorrhagic.

Ischemic stroke

Ischemic stroke is the more common of the two and accounts for about 87% of all strokes. It also accounts for 55% of pediatric strokes.

An ischemic stroke occurs when a blood clot obstructs a vessel that supplies blood to the brain. Usually, this is because fatty deposits that line the vessel walls, called atherosclerosis, cause an obstruction.

A blood clot that doctors refer to as a thrombus may develop in the fatty plaque inside a blood vessel.

A blood clot called a cerebral embolism may also form at another location in the circulatory system. Part of the clot may break away and travel to vessels in the brain that are too small for it to pass through.

Hemorrhagic strokes

About 13% of stroke cases are hemorrhagic. These occur when a weakened blood vessel ruptures and bleeds into the brain, where the blood gathers and compresses the surrounding brain tissue.

Hemorrhagic strokes can occur within the brain, called intracerebral, or on the surface of the brain, called subarachnoid hemorrhagic.

Doctors associate several conditions with pediatric stroke. These include:

To diagnose pediatric stroke, a doctor will typically review a child’s symptoms and medical history and perform a physical examination. They will then perform tests to help them make a diagnosis.

These may include:

The treatment for pediatric stroke may differ depending on a variety of factors, such as the age of the child, the type of stroke, the cause of the stroke, the area of the brain affected, and the extent of the damage.

Treatment may include:

  • clot-dissolving medication called tissue plasminogen activator (tPA), which doctors administer intravenously
  • thrombectomy, which is a minimally invasive procedure where doctors remove the clot from the blood vessel
  • treatment for any related seizures, infection, fever, or other symptoms
  • rehabilitation, such as speech therapy and occupational or physical therapy
  • close monitoring

The outlook varies for children with stroke. Prompt medical treatment and rehabilitation can result in better outcomes, and younger people typically recover more abilities than older people following a stroke.

A 2021 article notes that more than 75% of children who experience an arterial ischemic stroke experience long-term neurological deficits, and 19% experience recurrence.

Depending on the areas of the brain the stroke affects, some children may experience problems related to motor function, cognition, development, or seizures.

A stroke may result in complications, which can include:

  • cognitive and learning difficulties
  • neurological problems
  • problems with vision
  • physical and motor impairment
  • weakness or paralysis in an area of the body
  • communication difficulties
  • behavioral problems
  • psychological difficulties
  • seizures

The likelihood of a child having a stroke, or stroke recurrence, may depend on the underlying causes of the stroke. To help prevent stroke, a person can ensure that the child is:

  • taking blood-thinning, seizure control, and other medications as prescribed by a doctor
  • receiving treatment for underlying causes, such as cardiac problems or infection
  • exercising and eating a diet rich in fruits and vegetables and low in sodium
  • following up with the doctor regularly
  • staying aware of the risks of stroke as they age

Stroke may occur at any age and can affect children. Pediatric strokes may be ischemic or hemorrhagic and can present differently than they do in adults.

In children and teenagers, the symptoms may be similar to those of adults and can involve weakness, numbness, or paralysis in one side of the body, as well as confusion, difficulty speaking, or other focal deficits. In newborn babies and infants, seizures are the most common symptom of stroke.

Pediatric strokes are often related to cardiac issues, such as infections or diseases that affect the heart. However, doctors associate many other diseases and disorders with pediatric stroke.

The treatment of pediatric stroke may differ depending on the underlying causes, the child’s age, the area of the brain the stroke affects, and the extent of the damage.

Some children may experience long-term effects of stroke, which can include cognitive difficulties, developmental delays, and physical and motor impairment. Prompt treatment can improve a child’s outcome.