Can Strokes Occur in Children? What Are the Reasons?

India is quite stroke prone. While age over 65 years is considered a risk factor for stroke, in India stroke affects younger people as well. Time is of essence when dealing managing stroke as treating the patient within the golden window of 4 ½ hours is a decisive factor in recovery.

Stroke can lead to long-term neurological deficits – recovery might take a month, a year, and in some unfortunate cases, complete recovery might not be possible at all. The recovery depends on how soon a patient is treated following stroke.

As stroke is thought to affect only older people, its symptoms are often overlooked in young patients. Even if the symptoms are not missed, they are mistaken for something else. The thought that it could be a stroke just does not occur to most people.

Stroke in Children

A stroke can manifest at any stage of life, including in children. When strokes occur in children, they are referred to as pediatric strokes. Similar to adults, pediatric strokes can be categorized as ischemic or hemorrhagic strokes, but the characteristics and causes of these strokes differ from those in adults.

• An ischemic stroke occurs because of a block in the artery or vein.
• An ischemic stroke can also occur during the birth of the child when there is a birth injury. This is called a presumed perinatal stroke.
• Even inside the mother’s womb it is possible for the child to suffer an ischemic stroke. This is called a fetal stroke.
• An ischemic stroke experienced by the child soon after delivery is known as a neonatal stroke.

Causes of Stroke in Children

Causes for Ischemic Arterial Stroke

• Abnormalities in the heart
• Infection or trauma could happen when the baby is coming through the birth canal
• Very low hemoglobin
• Sometimes chicken pox can lead to ischemic stroke in children as it tends to thicken the blood
• Conditions that occur in the arteries themselves during birth (arteriopathy) – the walls of the artery are not normal and congenital defects are present
• Primary CNS vasculitis – the blood vessels of the brain are abnormally inflamed

Causes for Ischemic Venous Stroke

• Infections
• Fever
• Dehydration
• Clotting disorder at birth

Causes for Hemorrhagic Stroke

• Hemorrhagic disease of new born
• Ventilation for premature babies can precipitate intra ventricular hemorrhages and cause a stroke

Stroke Symptoms in the Younger Generation

It is important to be aware of the symptoms of  stroke when younger adults are affected.

• Severe headache with no known cause is the most common symptom.
• Sudden numbness or weakness of face, arm or leg, which usually affects just one side of the body.
• Sudden confusion, trouble speaking or understanding speech.
• Sudden trouble with vision in one or both eyes.
• Sudden trouble with walking, sudden dizziness, loss of balance or coordination.

Other subtle symptoms:

• Vertigo – the patient may feel the room is spinning.
• Slurred speech (or dysarthria) which might even manifest as mispronounced words and not actual slurring of speech. In some cases, patients might not be able to find the right words to express themselves – this is called word finding difficulty.
• Double vision or other vision problems.
• Nausea and vomiting with headache.

The symptoms are also dependent on the part of the brain that is affected – whether it is the anterior side or the posterior side. Thus, symptoms can also help in identifying the affected blood vessel.

Risk Factors in Young Adults

Having the following risk factors increases the possibility of a stroke attack:

• Hypertension
• Diabetes
• Previous stroke attacks
• Family history of cerebrovascular disease
• Dyslipidemia
• Illicit drug use
• Valvular heart disease
• Cardiomyopathy
• Atrial fibrillation
• Coronary artery disease
• Metabolic disorders
• High alcohol intake
• Smoking

Pre-Strokes Should Not Be Ignored

While people are made aware that stroke symptoms should not be ignored and warrant a doctor consult, so too should they know that they cannot ignore a pre-stroke or a mini stroke.

• A pre-stroke may last only a few minutes. It will cause minimal weakness, changes in speech, vision, balance and does not cause permanent damage. As a result, patients have a tendency to ignore it.
• However, it is a sign of warning of an impending stroke, an attack that can happen in the following months, days or even hours.
• The doctor will conduct a physical examination to find out if any neurological deficit was left behind by the pre-stroke. He/she will evaluate the patient’s speech, eye movement, reflexes, strength and sensory system.
• The doctor will also perform some diagnostic tests like CT scan, MRI, etc.

When a pre-stroke is identified in time and treated, 35% of strokes can be averted.

Stroke is preventable and treatable. By recognizing the signs of stroke and acting quickly, we can reduce the stroke burden of our country.

 

Frequently Asked Questions

Can children have strokes?

Yes, children can have strokes. These are known as pediatric strokes and can occur even before birth or shortly after delivery.

What are the common causes of strokes in children?

Common causes include heart abnormalities, infections, low hemoglobin, and congenital defects in the arteries.

What symptoms should parents watch for in children regarding strokes?

Symptoms include severe headache, sudden numbness or weakness on one side of the body, confusion, trouble speaking, vision problems, and loss of balance.

What is the difference between an ischemic and a hemorrhagic stroke in children?

An ischemic stroke is caused by a blockage in an artery or vein, while a hemorrhagic stroke is caused by bleeding in the brain.

How can early intervention help in stroke recovery for children?

Early intervention within the golden window of 4 ½ hours is crucial for effective treatment and can significantly improve recovery outcomes.

Are there risk factors for strokes in young adults?

Yes, risk factors include hypertension, diabetes, family history, smoking, and high alcohol intake.

 

Kauvery Hospital is globally known for its multidisciplinary services at all its Centers of Excellence, and for its comprehensive, Avant-Grade technology, especially in diagnostics and remedial care in heart diseases, transplantation, vascular and neurosciences medicine. Located in the heart of Trichy (Tennur, Royal Road and Alexandria Road (Cantonment), Chennai, Hosur, Salem, Tirunelveli and Bengaluru, the hospital also renders adult and pediatric trauma care.

Chennai – Alwarpet/Vadapalani 044 4000 6000 • Trichy – Cantonment – 0431 4077777 • Trichy – Heartcity – 0431 4003500 • Trichy – Tennur – 0431 4022555 • Hosur – 04344 272727 • Salem – 0427 2677777 • Tirunelveli – 0462 4006000 • Bengaluru – 080 6801 6801