Stroke can occur at any age — even in children, infants, and babies in the womb. Stroke in children has different symptoms and causes, and a different recovery outlook, than it does in adults, but getting effective care fast is still the key to a good outcome.
Stroke is one of the top 10 causes of death in children. Stroke occurs in 11 in 100,000 children younger than 18 years each year, with the risk being greatest right before or right after birth. Raising awareness of the risk factors and warning signs can help people seek expert medical attention faster, which can reduce complications and speed up recovery.
Children rarely have the risk factors associated with adult stroke, such as high blood pressure or arteriosclerosis. Other conditions can raise the risk of stroke for children, including heart defects, sickle cell disease, hemophilia, other clotting diseases, and injuries to the head or neck. Certain conditions during pregnancy, such as high blood pressure or an infection of the fluid around the baby, can raise the risk of stroke in babies before or just after birth, as well.
Stroke can look different in teens, children, and infants. While the signs to look for in adults — facial drooping, slurred speech, or weakness on one side of the body — can also occur in children, they may be harder to detect. Other signs may be more obvious, but they can look like other conditions. For example, newborns and infants may be difficult to wake or engage, or they may have seizures with twitching or interrupted breathing. In children and teens, stroke may present as a sudden and severe headache, vomiting, dizziness, confusion, or loss of coordination. These symptoms, especially if they occur after an injury, should be checked by a doctor immediately.
Stroke in children is a medical emergency in which time is essential, just like in adults. The two types of stroke also occur in children: ischemic stroke, caused by a blood clot that blocks blood flow to the brain, and hemorrhagic stroke, in which a burst blood vessel cuts off the blood supply. But treatment of stroke in children is often very different from adult stroke treatment. The lifesaving drug that has revolutionized treatment of adult ischemic strokes, called tissue plasminogen activator (tPA), has not been studied enough to determine its safety and effectiveness in children. At this point, clinicians choose this approach under very limited circumstances.
Treatment instead might include blood transfusions (for those with sickle cell disease), relieving pressure on the brain through surgery or other means, or medications to bring down blood pressure, prevent blood clots from forming, or control seizures.
A child's developing brain often recovers faster and more completely after a stroke than an adult brain. But children may also experience lasting effects, such as weakness or inability to use one side of the body, speech and vision problems, mood swings, and learning or behavioral difficulties.
The pace of discovery of stroke research — including stroke in children — is accelerating, bringing new treatments and hope to children and their families after stroke.