Pediatric Stroke Awareness

A Stroke Can Happen at Any Age - click to watch a video on awareness
Understand the F.A.S.T. system to save the life of a child

F for Face: Ask the child to smile. Does the smile droop on one side?

A for Arms: Ask the child to raise his/her arms. Is one-sided weakness or difficulty apparent?

S for Speech: Ask the child to repeat a simple sentence. Do words sound slurred or is it
difficult to repeat?

T for Time: Time is Critical! Call 9-1-1 if any of the signs above are apparent.

If you think your infant or children has had a stroke, please don’t hesitate to take action.
Early diagnosis is very important. You are your child’s best advocate!
What is a Pediatric Stroke?
There are two types of strokes:
  • Ischemic stroke is brain damage resulting from the blockage of a blood vessel, typically by a blood clot.
  • Hemorrhagic stroke is bleeding into the brain from the rupture of a blood vessel.
Pediatric Stroke can occur at any time even before the child is born. You might hear several different terms to describe this.
  • Perinatal, prenatal or in utero all refer to strokes occurring before birth.
  • Neonatal or newborn refers to strokes occurring from birth up to one month of age.
  • Childhood refers to strokes occurring from one month up to 18 years old.
What is the Occurrence of Pediatric Stroke?

Perinatal stroke occurs in roughly 1 in 4,000 births.

For children 1 month-18 years old, stroke occurs in roughly 10 out of 100,000 children. About half of those strokes are due to hemorrhage and the other half due to blockade of an artery.

5-10% of children will die from their stroke.

Pediatric Stroke is the 6th leading cause of death in children.
What are the Signs and Symptoms of Pediatric Stroke?
Infants
  • Seizures in one area of the body, such as an arm or a leg
  • Infantile spasms (clusters of “little” seizures consisting of a sudden jerk followed by stiffing of the body)
  • Problems eating
  • Trouble breathing or pauses in breathing (apnea)
  • Early preference for use of one hand over the other
  • Developmental delays, such as rolling over and crawling later than usual
Children
  • Seizures
  • Headaches, possibly with vomiting
  • Sudden paralysis or weakness on one side of the body
  • Language or speech delays or changes, such as slurring
  • Trouble swallowing
  • Vision problems, such as blurred or double vision
  • Tendency to not use one of the arms or hands
  • Tightness or restricted movement in the arms and legs
  • Difficulty with schoolwork
  • Memory loss
  • Sudden mood or behavioral changes
Why is diagnosis of Pediatric Stroke missed or delayed?
  • An infant commonly may not present with symptoms for several months as his/her brain has not matured enough to show symptoms of a stroke.
  • Non-use of affected upper limb is wrongly attributed to normal hand preference.
  • Delays in crawling and walking are wrongly attributed to normal “lateness.”
  • Many children who have suffered a stroke develop normal or near-normal language and cognitive functioning, therefore not raising suspicion.
  • Many children with stroke syndromes are misdiagnosed with more common conditions that mimic stroke, such as migraines, epilepsy or viral illnesses.
What are some common causes of Pediatric Stroke?
  • Lack of oxygen during birth
  • Cardiac disorders
  • Hematological disorders
  • Vascular disorders
  • Metabolic disorders
  • Infection, including chicken pox or meningitis
  • A head injury resulting in broken blood vessel
  • An aneurysm (weakness in an artery wall)
  • Diseases that affect blood clotting, such as hemophilia

In roughly 33% of newborns and 25% of children, no explanation is found.
What are the long term effects of Pediatric Stroke?
More than 85% of newborns who have a stroke survive to adulthood.
More than 50% of infants and children will have significant long term neurological disabilities including:
  • Cerebral Palsy (brain injury or abnormal brain development that occurs before, during or just after birth)
  • Hemiplegia (one-sided paralysis)
  • Hemiparesis (one-sided weakness)
  • One sided neglect or ignoring weaker side
  • Seizures
  • Aphasia (difficulty with speech and language)
  • Dysphagia (trouble swallowing)
  • Vision problems
  • Changes in mood
  • Cognitive changes
  • Problems with memory, judgment or problem solving
  • Behavior or personality changes or problems
  • Learning difficulties