Study: Children Can Have Recurrent Strokes

August 8, 2010 — Children can have strokes, and the strokes can recur, usually within a month, according to pediatric researchers. Unfortunately, the strokes often go unrecognized the first time, and the child does not receive treatment before the recurrence.

Pediatric neurologist Rebecca Ichord, MD, director of the Pediatric Stroke Program at The Children's Hospital of Philadelphia, reported today on a study of arterial ischemic stroke in children at the International Stroke Conference 2010 in San Antonio, TX. The conference was sponsored by the American Stroke Association.

An arterial ischemic stroke results from a blockage or constriction in an artery in or leading to the brain.

About the pediatric stroke study

Ichord and colleagues at The Children's Hospital of Philadelphia followed 90 children with a median age of about 6 years old, who were treated for stroke between 2003 and 2009. Twelve patients (13 percent) had a recurrent stroke during the study period, most of them within a month of the first stroke. In six of the 12 children with recurrent strokes, no one diagnosed the initial stroke until a recurrent stroke occurred.

"Strokes don't occur only in the elderly," said Ichord. "They can also affect children as young as infants. Our findings reinforce how important it is to diagnose stroke in children as quickly as possible so that medical caregivers can provide emergency treatment and take measures to prevent recurrence."

Why children have strokes

Strokes can arise in children for various reasons:

• As a complication of other illnesses, such as sickle cell disease, which obstructs blood circulation
• From an undetected heart condition
• Due to a whiplash injury to the neck that damages an artery and leaves it vulnerable to a blood clot that causes a stroke

Stroke symptoms in children

Signs of a stroke in children are the same as in adults:

• Sudden loss of neurologic functions such as vision or speech
• Unsteady gait
• Weakness on one side of the face or in limbs

What is different in children, said Ichord, is that symptoms may be subtle, examination is difficult and children are less able to describe their symptoms.

Emergency treatment for a child's stroke

Emergency treatment for a stroke typically involves:

• Assuring adequate breathing and circulation
• Supplying intravenous fluids
• Improving blood supply to the brain
• Giving medications such as aspirin or blood thinners to lower the risk of a recurrent stroke

In the aftermath of a stroke, rehabilitation is critical to promote recovery.

"Because a stroke can recur, we need improved awareness of pediatric stroke among primary healthcare providers, and more research on the best ways to prevent a recurrence after a child suffers a first stroke," added Ichord.

Pediatric stroke care at The Children's Hospital of Philadelphia

For more information about pediatric stroke care at The Children's Hospital of Philadelphia, visit the Pediatric Stroke Program.