Obesity, heart defects and narrowing of the arteries are risk factors for stroke. In addition to adults, embryos, newborns, children and adolescents can also be affected. When children have a stroke, they recover more easily from a stroke than adults because their brains are more flexible.
What characterizes a stroke in children?
As in adults, strokes in children are also circulatory disorders of the brain. A blood clot in the cerebral arteries is usually the cause. Such clots result in ischemic loss of nerve tissue. The brain or parts of the brain are no longer supplied with sufficient oxygen and nerve tissue dies. Around 500 children and adolescents under the age of 18 suffer a stroke in Germany every year. See biotionary for What does LSE stand for.
The number of unreported cases is estimated to be higher because doctors rarely think of a stroke in children. Child strokes occur in one third of all cases during birth and are then caused by the natal stress. Some children also have prenatal strokes. So you are affected by a stroke while still in the womb.
In adults, the causes of a stroke are often hardened or narrowed arteries. In childhood, other causes are usually responsible for the circulatory disorders in the brain. Infections such as chickenpox are linked to the risk of stroke at a young age. The circulatory disorder in preschool children most often occurs as a result of an infection.
At the beginning of puberty, taking birth control pills in girls can increase the risk of stroke. Smoking during this time can also increase the risk of a stroke. In some cases, the cerebral arteries are also injured by jerky movements, for example when doing sports or riding roller coasters. This phenomenon mainly affects young people. Children with heart defects, high blood pressure, overweight or narrowed arteries are generally at higher risk of having a stroke.
Symptoms, Ailments & Signs
Severe headaches are the most common symptom parents seek medical help with their children after a stroke. However, strokes can also manifest as general muscle weakness on a specific side of the body, cause twitching on one side of the body, or cause an unsteady gait. Difficulty swallowing, slurred speech, numbness and visual disturbances are also warning signs that can indicate a stroke.
In extreme cases, even hemiplegia can occur. Above all, the prenatal and birth form of the stroke only rarely shows prompt symptoms. Affected children may use one side of the body less than the other when they first try to grasp. One half of the body may also be used less when crawling. In the case of prenatal and birth strokes, however, there are several months between the actual stroke and the symptoms.
Diagnosis & course of disease
Diagnosing a stroke is difficult, especially in younger children. This is especially true because younger patients can hardly describe their symptoms in the anamnesis. Movement tests and vision tests are carried out for diagnosis. Blood tests can also be used as a diagnostic tool. Sonography of the carotid arteries is performed to detect narrowing of the cerebral arteries.
Shortly after a stroke caused by blood clots, the veins also show bulges caused by the infused clot. An imaging method such as CT or MRI is used to identify the affected brain regions. If there are lesions in the tissue of the brain, then these lesions can also have inflammatory causes.
A cerebrospinal fluid puncture may be necessary to rule out inflammation and bacterial infections. The prognosis for childhood strokes is better than for adult strokes.
Since children cannot be asked about their symptoms like adults, it is difficult to diagnose a stroke in very young patients. In general, the prognosis for children is more favorable than for adults, but a number of problems must still be expected.
A stroke can impair the development of motor skills and lead to severe movement disorders. In these cases, the affected child often has to deal with a lengthy combination of physiotherapeutic and ergotherapeutic measures, which can often only be reconciled with the professional obligations of the parents and the everyday life of the family.
Speech and swallowing disorders are also not uncommon complications that occur in children after a stroke and then require speech therapy treatment. More serious complications that must also be taken into account include neuropsychological side effects that affect the patient’s behavior and cognitive abilities.
These disorders can very often be remedied by starting adequate therapy in good time, but here too those affected have to be prepared for lengthy treatment. In addition, a permanent reduction in cognitive abilities cannot be ruled out. These often only become noticeable during school enrolment, when children become conspicuous after a stroke due to concentration disorders and learning difficulties. These children then need special support.
When should you go to the doctor?
Fortunately, it’s not that common, but a stroke in children should always be treated by an appropriate doctor. If the first symptoms that indicate a stroke can already be recognized, no time must be wasted. An ambulance must be called immediately to provide first aid. Time is of the essence when it comes to stroke, so don’t delay in calling 112.
The faster first aid can be given, the better the chances of a full cure and recovery. If there is a delay in the provision of first aid, permanent damage may be left behind for the person concerned. For this reason, rapid first aid is particularly important for a child. Therefore, a doctor should be consulted or called immediately at the first symptoms. This can ensure that a quick and full recovery can take place.
Treatment & Therapy
Child stroke is treated depending on the causes and symptoms. Modern therapies for adults have not yet been approved for children, such as lysis treatment. If the stroke has caused movement disorders, physiotherapy treatment is recommended. Thanks to the Bobath concept, the children can regain lost movement sequences.
Occupational therapy can also be helpful in this context. If speech disorders or swallowing disorders are present, speech therapy care is essential. Because childhood strokes often impact children’s behavior, an experienced neuropsychologist should also assess cognitive and psychological disorders and limitations. Since a child’s brain is still developing, there is a good chance of a full recovery with regular and long-term training.
Children’s brains are much more flexible than adult brains. The nervous tissue is less specialized. In this way, other parts of the brain may be trained to take over the functions of the failed area. To prevent another stroke from occurring, prophylaxis must be carried out. This prophylaxis must be designed individually for each individual case.
Because after the affected children have started school, long-term effects such as an inability to concentrate often only become noticeable, the affected children are usually supported for a longer period of time than adult stroke patients.
A prenatal or natal stroke can hardly be prevented. However, the consumption of harmful substances during pregnancy can increase the risk as the embryo is subjected to more stress. After birth, the general risk of a stroke can be estimated using sonography and blood tests, so that general prophylaxis can be developed for risk patients.
After a stroke in a child, comprehensive follow-up care is necessary. Affected children suffer from extensive complaints that often have to be treated for months and years. Follow-up care includes physical therapy, physical exams, and other measures, the amount of which depends on how badly damaged the child is from the stroke.
As a rule, follow-up care takes place as part of neurological rehabilitation. A stroke in children is treated in a special clinic. The stroke aftercare is designed by the pediatrician or the neurologist. Expert aftercare prevents long-term consequences by recognizing complications and including them in further therapy.
Affected children often have serious underlying diseases, which must be treated in addition to stroke therapy. It is best for the parents to contact the specialist and discuss how to proceed with them. The general practitioners must be intensively involved in the follow-up care.
Comprehensive follow-up care can significantly reduce the risk of another stroke. As part of the aftercare, the diet must also be changed. In addition, the parents must be informed about possible risk factors such as high blood pressure or an elevated cholesterol level and trained in the use of the measuring devices.
You can do that yourself
A stroke is a life-threatening condition. It is often difficult for the person affected to handle. The burden is all the greater when the patient is a child. Naturally, this cannot react sufficiently to the situation or strive for changes. In the area of self-help, it is therefore mostly the relatives and parents who are responsible for making optimisations.
Stressors are to be tracked down and should, if possible, be completely eliminated or significantly reduced. If the circumstances or experiences of the past represent a particular burden for the child, improvements should be sought. A harmonious environment, the avoidance of conflicts and the demands placed on the child must be checked. Leisure activities, food intake and sleep hygiene should be adapted to the natural needs of a child. If the child has already experienced serious illnesses in the past, it should be checked whether psychological support can be helpful.
The overall situation should be discussed openly and honestly with the child. The child’s wishes and questions must be taken into account in everyday life or should be answered truthfully. Since the stroke is often associated with long-term symptoms, it is advisable to adapt the organization of everyday life or leisure time to the patient’s possibilities.