Pediatric Stroke
WHAT YOU NEED TO KNOW:
What is a stroke?
A stroke happens when blood flow to part of the brain is interrupted. This can cause serious brain damage from a lack of oxygen. Brain function may be affected depending on where the stroke happens. A stroke can happen when your child is still in the womb, or at any age after birth. A stroke caused by a blood clot is called an ischemic stroke. A stroke caused by a burst or torn blood vessel is called a hemorrhagic stroke. Hemorrhagic stroke is more common than ischemic stroke in children. When stroke symptoms last a few hours and do not cause damage, it is called a transient ischemic attack (TIA). A TIA may be a warning sign that your child is about to have a stroke.
What are the warning signs of a stroke?
The word F.A.S.T. can help you remember and recognize warning signs of a stroke.
What are the signs and symptoms of a stroke in a child?
Signs and symptoms will depend on your child's age, the type of stroke he had, and where it occurred:
What increases my child's risk for a stroke?
How is a stroke diagnosed?
How is a stroke treated?
Treatment depends on your child's age and the type of stroke he had.
What can I do to care for my child after a stroke?
How can a stroke in children be prevented?
Help prevent another stroke in your child:
Call 119 or go to the hospital for any of the following:
When should I seek immediate care?
When should I contact my child's healthcare provider?
Discharge Care:
Follow up with your child's healthcare provider as directed:
Your child may need to go in for regular tests of his brain function.
If he is taking warfarin, (Coumadin) he will need to go in for regular blood tests.
His INR levels will also need to be checked. These tests help make sure he is taking the right amount of warfarin.
Write down your questions so you remember to ask them during your visits.
Medicines:
Medicines will depend on the kind of stroke your child had. He may need any of the following:
CARE AGREEMENT:
You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want your child to receive. As your child's advocate, You always have the right to refuse treatment.
What is a stroke?
A stroke happens when blood flow to part of the brain is interrupted. This can cause serious brain damage from a lack of oxygen. Brain function may be affected depending on where the stroke happens. A stroke can happen when your child is still in the womb, or at any age after birth. A stroke caused by a blood clot is called an ischemic stroke. A stroke caused by a burst or torn blood vessel is called a hemorrhagic stroke. Hemorrhagic stroke is more common than ischemic stroke in children. When stroke symptoms last a few hours and do not cause damage, it is called a transient ischemic attack (TIA). A TIA may be a warning sign that your child is about to have a stroke.
What are the warning signs of a stroke?
The word F.A.S.T. can help you remember and recognize warning signs of a stroke.
- F = Face: One side of the face droops.
- A = Arms: One arm starts to drop when both arms are raised.
- S = Speech: Speech is slurred or sounds different than usual.
- T = Time: A person who is having a stroke needs to be taken to the hospital immediately. A stroke is a medical emergency that needs immediate treatment. Some medicines and treatments work best if given within a few hours of a stroke.
What are the signs and symptoms of a stroke in a child?
Signs and symptoms will depend on your child's age, the type of stroke he had, and where it occurred:
- Seizures or vision changes
- Headache, vomiting, or a fever
- Developmental delays that appear years after a stroke, or trouble doing schoolwork
- Sudden weakness in an arm or leg, or trouble walking
- Sudden trouble speaking or showing body language or gestures
- Paralysis on one side of his body, or a tendency to use only one arm
- Loss of consciousness
What increases my child's risk for a stroke?
- Congenital heart disease, such as atrial septal defect, or acquired heart disease, such as endocarditis
- Sickle cell anemia, Fabry disease, or leukemia
- A medical condition such as inflammatory bowel disease or an autoimmune disorder that affects brain arteries
- A vascular disease, blood clotting disorder, or brain tumor
- High blood pressure, diabetes, or dehydration
- Not enough physical activity, or obesity
- A family history of stroke or certain heart conditions
- An infection in his head or neck, or a head injury
- An infection in the amniotic fluid during pregnancy, or membranes in the womb ruptured prematurely
- His mother had preeclampsia (high blood pressure during pregnancy)
How is a stroke diagnosed?
- Blood tests may be used to check how well your child's blood clots or to check for infection.
- CT or MRI pictures may be used to find the area of the brain that was affected by the stroke. The pictures may also show bleeding in your child's brain. Do not let your child enter the MRI room with anything metal. Metal can cause serious injury. Tell the healthcare provider if your child has any metal in or on his body.
- Arteriography is a test that uses a type of x-ray. Pictures are taken of your child's arteries to look for blood flow blockage and bleeding. Contrast liquid may be injected into your child's arteries to help the arteries show up on x-ray. Tell the healthcare provider if your child has ever had an allergic reaction to contrast liquid.
- A lumbar puncture, or spinal tap, may be used to check for infection.
How is a stroke treated?
Treatment depends on your child's age and the type of stroke he had.
- Medicines may be given to prevent blood clots, break up clots, or help your child's blood clot more easily. He may need medicines to treat high cholesterol, high blood pressure, or diabetes. He may also need medicine to control seizures.
- Monitoring of your child's neurological abilities include checking his reflexes and eye movements and ability to speak. Healthcare providers will check your child's reactions to light, sound, and touch. Physical abilities, such as being able to swallow and move, will also be monitored.
- Thrombolysis is a procedure used to break apart clots in an artery. A catheter is guided into the artery until it is near the clot. Medicine is put through the catheter that will help break apart the clot.
- Surgery may be used to remove a blood clot or to relieve pressure within your child's brain. He may also need surgery to place a clip to stop blood flow into an artery in his brain.
What can I do to care for my child after a stroke?
- Take your child to rehabilitation (rehab) as directed. Rehab is an important part of treatment. A child's brain may be able to adapt to loss of function better than an adult's brain. Rehab can help your child relearn how to walk, read, or do other activities lost because of the stroke. A speech therapist helps your child relearn or improve his ability to talk and swallow. Physical therapists can help your child gain strength and build endurance. Occupational therapists teach your child new ways to do daily activities, such as getting dressed. Therapy can help your child improve his ability to walk or keep his balance. Take your child to rehab right away. The earlier your child starts rehab, the more effective it will be.
- Make your child's home safe. Your child may have trouble walking or keeping his balance after a stroke. Remove anything he might trip over. Tape electrical cords down. Keep paths clear throughout your home. Make sure your home is well lighted. Put nonslip materials on surfaces that might be slippery. An example is your bathtub or shower floor.
- Help your child use assistive devices. Your child may need to use a walker or other device to help him keep his balance as he walks.
How can a stroke in children be prevented?
Help prevent another stroke in your child:
- Talk to your child about not smoking. Nicotine and other chemicals in cigarettes and cigars can increase your child's risk for another stroke and cause lung damage. Ask your healthcare provider for information if your older child currently smokes and needs help to quit. E-cigarettes or smokeless tobacco still contain nicotine. Talk to your healthcare provider before you use these products.
- Manage health conditions. Conditions such as sickle cell anemia increase your child's risk for another stroke. He may be able to get blood transfusions to prevent a stroke if he has sickle cell anemia.
- Offer your child a variety of healthy foods. Healthy foods include whole-grain breads, low-fat dairy products, beans, lean meats, and fish. Your child should eat at least 5 servings of fruits and vegetables each day. Offer foods that are low in fat, cholesterol, salt, and sugar. Choose foods that are high in potassium, such as potatoes and bananas.
- Have your child exercise as directed. Activity is important for preventing another stroke. Exercise may help your child be able to do his normal activities more easily. Exercise also helps control blood pressure and weight.
- Help your child maintain a healthy weight. Ask your healthcare provider how much your child should weigh. Ask him to help you create a weight loss plan if your child is overweight.
- Check your child's blood pressure as directed. High blood pressure can increase your child's risk for a stroke. If he has high blood pressure, follow your healthcare provider's directions for controlling his blood pressure.
Call 119 or go to the hospital for any of the following:
- Your child has any of the following signs of a stroke:
- Numbness or drooping on one side of your face
- Weakness in an arm or leg
- Confusion or difficulty speaking
- Dizziness, a severe headache, or vision loss
- Your child has a seizure.
- Your child's arm or leg is warm, tender, and painful. It may look swollen and red.
- Your child feels lightheaded, short of breath, and has chest pain.
- Your child coughs up blood.
When should I seek immediate care?
- Your child is bleeding from his rectum or nose.
- Your child has vision loss or a severe headache.
When should I contact my child's healthcare provider?
- Your child's blood pressure is higher or lower than you were told it should be.
- Your child has trouble having a bowel movement or urinating.
- You have questions or concerns about your child's condition or care.
Discharge Care:
Follow up with your child's healthcare provider as directed:
Your child may need to go in for regular tests of his brain function.
If he is taking warfarin, (Coumadin) he will need to go in for regular blood tests.
His INR levels will also need to be checked. These tests help make sure he is taking the right amount of warfarin.
Write down your questions so you remember to ask them during your visits.
Medicines:
Medicines will depend on the kind of stroke your child had. He may need any of the following:
- Medicines may be given medicine to help his blood clot more easily if he had a hemorrhagic stroke. He may also need medicine to control seizures, high cholesterol, high blood pressure, or diabetes.
- Blood thinners
- Watch for bleeding and bruising while you take blood thinners. Watch for bleeding from your gums or nose. Watch for blood in your urine and bowel movements. Use a soft washcloth on your skin, and a soft toothbrush to brush your teeth. This can keep your skin and gums from bleeding. If you shave, use an electric shaver. Do not play contact sports.
- Tell your dentist and other healthcare providers that you take anticoagulants. Wear a bracelet or necklace that says you take this medicine.
- Do not start or stop any medicines unless your healthcare provider tells you to. Many medicines cannot be used with blood thinners.
- Tell your healthcare provider right away if you forget to take the medicine, or if you take too much.
- Warfarin (Coumadin) is a blood thinner that your child may need to take. The following are things you should be aware of if your child takes warfarin.
- Foods and medicines can affect the amount of warfarin in your blood. Do not make major changes to your diet while you take warfarin. Warfarin works best when you eat about the same amount of vitamin K every day. Vitamin K is found in green leafy vegetables and certain other foods. Ask for more information about what to eat when you are taking warfarin.
- You will need to see your healthcare provider for follow-up visits when you are on . You will need regular blood tests. These tests are used to decide how much medicine you need.
- Antiplatelets, such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
- Give your child's medicine as directed.
- Call your child's healthcare provider if you think the medicine is not working as expected. Tell him if your child is allergic to any medicine. Keep a current list of the medicines, vitamins, and herbs your child takes. Include the amounts, and when, how, and why they are taken. Bring the list or the medicines in their containers to follow-up visits. Carry your child's medicine list with you in case of an emergency.
CARE AGREEMENT:
You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want your child to receive. As your child's advocate, You always have the right to refuse treatment.