What is a stroke?
A stroke is a type of cardiovascular disease that affects the arteries leading to and within the brain. A stroke occurs when a blood vessel that carries oxygen and nutrients to the brain is either blocked by a clot or bursts. When that happens, the part of the brain that cannot get the blood (and oxygen) it needs begins to die.

When a stroke occurs, getting to the hospital quickly can make all the difference.

What are the signs that a child may have had a stroke?
Infants may have seizures or have weakness in one arm and leg. Children and adolescents may have headache, numbness, or weakness in one arm or leg, asymmetric facial features, difficulty speaking, or loss of balance.

How are strokes treated in children?
The treatment for stroke depends upon the cause. Some children will require anticoagulation medication to increase the blood flow to the brain. Others will require antiplatelet agents (aspirin). Clot busters, such as tissue plasminogen activator (tPa), are not yet approved in children, but studies are being conducted.

Will my child fully recover from a stroke?
Many children, especially if they are very young, can recover completely or quite well from a stroke. Important issues for recovery are the size and location of the stroke and whether risk factors for stroke can be identified and treated. Rehabilitation by means of physical therapy, occupational therapy, and speech therapy is extremely important for long-term outcome.

What tests will my child need to be evaluated for a stroke?
In the emergency department, your child will need a CT scan to make sure there is no bleeding in the brain. The emergency room doctors and the neurologist will examine your child for any neurologic loss. Eventually, an MRI of the brain as well as an MR angiogram will be done to evaluate the extent of the stroke and to visualize the child’s blood vessels in detail.

The neurologist will determine whether your child needs anticoagulation medication with IV heparin, depending on the brain imaging. If your child does not require anticoagulation, he or she might receive daily aspirin. Other tests may be needed later based upon your child’s symptoms.

After your child is admitted to the hospital, he or she will likely need an echocardiogram of the heart. This is done to see if the heart has a normal structure and to make sure that there are no clots that could have gone to the brain. Even if no risk factors are found during the hospital stay, your child will still require rehabilitation services and will be followed in the neurology clinic after discharge from the hospital.