Childhood Stroke

A stroke happens when blood cannot reach all parts of the brain. Blood carries oxygen and nutrients to brain cells, flowing through blood vessels called arteries and veins. If blood cannot get through, the brain can be injured.

Stroke can happen at any age, but it is relatively rare in children. Perinatal stroke happens before birth or shortly after, between about 28 weeks of pregnancy and one month of age. Childhood stroke happens in a child aged from one month to 18 years.

Types of stroke#

There are three main types:

• Ischaemic stroke – caused by an artery being blocked. It is also called arterial ischaemic stroke (AIS).
• Haemorrhagic stroke – caused by bleeding when an artery breaks.
• Cerebral sinovenous thrombosis – caused by a blood clot in a vein.

Signs of stroke#

In babies, there may be no signs while the stroke is happening. Over time you may notice changes in how your baby develops, such as a tendency to use only one side of the body. Babies may also be extremely sleepy.

In toddlers, children and teenagers, signs can include:

• weakness or numbness in the face, arm or leg, especially on one side
• difficulty speaking, understanding, reading or writing
• trouble seeing or loss of vision
• dizziness, loss of balance or poor coordination
• nausea or vomiting
• difficulty swallowing, including drooling
• severe or unusual headaches
• seizures with weakness that does not improve
• changes in behaviour and difficulty concentrating

Stroke can sometimes cause a child to collapse.

If you notice any of these signs, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) immediately. Even if you are not sure, or the signs only last a few minutes, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) .

If your child has had a stroke, talk with their doctors about the signs to watch for, and pass this information on to family, friends, childcare and school.

Causes of stroke#

Many parents worry that they caused their child’s stroke. This is not the case.

Causes of perinatal stroke (before or shortly after birth) can include:

• complications and difficulties during pregnancy or birth
• heart problems
• blood clotting disorders

Causes of childhood stroke (one month to 18 years) can include problems with the brain’s blood vessels and other conditions:

• vasculitis, which can make a blood vessel narrow or weak
• focal cerebral arteriopathy (FCA), which can make blood vessels narrow
• head or neck trauma, which can cause a blood clot to form or blood to leak from a vessel
• moyamoya disease, which can make blood vessels narrow and blocked
• an arteriovenous malformation (AVM), a tangled mass of blood vessels in the brain that can burst
• a cavernous malformation, a cluster of abnormal blood vessels that can leak
• an aneurysm
• problems with the heart, or heart surgery
• blood clotting or other disorders

How stroke can affect children#

The effects of stroke are different for every child. How a child is affected depends on which area of the brain was injured and how badly. The brain controls everything a child thinks, feels, says and does, so a stroke can affect:

• walking and moving
• speaking, understanding, reading and writing
• thinking, memory and judgement
• personality, behaviour and emotions
• vision, touch, taste and smell

Children can also experience pain and fatigue after a stroke, and recurrent seizures (epilepsy) can develop. Effects may be minor or more serious, and may become more obvious as your child develops. Effects can also improve over time.

Tests and treatment#

Tests may include brain scans, heart tests and blood tests. Treatment aims to limit the injury to the brain and reduce the risk of another stroke. Your child’s doctor will discuss whether treatment is appropriate and safe for your child.

Ischaemic stroke – there are early treatments that can unblock the artery so blood can get through. Surgery may be needed to relieve pressure caused by swelling in the brain.

Haemorrhagic stroke – surgery may be needed to repair the damaged artery and stop the bleeding, relieve the pressure caused by a build-up of blood, or seal or remove an aneurysm or arteriovenous malformation.

Therapy and recovery#

After a stroke, children need access to therapy to support their development and recovery. Therapies may include physiotherapy, speech therapy, occupational therapy and psychology, and should begin as soon as possible. Early intervention is for babies and very young children.

Rehabilitation is for older children#

After that, therapy options depend on what is best for your child and what is available where you live.

Therapy teams play a key role when your child is ready to start or return to childcare or school. They help make sure carers and teachers understand your child’s stroke and are prepared. A neuropsychology assessment can help identify educational, emotional, social and other needs. Your child may need extra help with schoolwork, special equipment or reduced hours at school.

The impact of stroke can change over time, as can the support needed#

If you notice any of the signs of stroke, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) immediately. Even if you are not sure, or the signs go away, call your local emergency number (for example 911 in the US and Canada, 112 across the EU and many countries, 999 in the UK, or 000 in Australia) .

Key points#

• A stroke is when blood can’t get to all parts of the brain.
• The main types are ischaemic stroke (a blocked artery), haemorrhagic stroke (bleeding when an artery breaks) and cerebral sinovenous thrombosis (a clot in a vein).
• Stroke can sometimes cause children to collapse.
• Many parents worry that they caused their child’s stroke, but this is not the case.
• If you notice any signs of stroke, call emergency services immediately.

Where to get help#