Pediatric stroke

Resident nurse: First of all, you should know that strokes can happen to anyone at any time, including teenagers, children, newborns and even unborn babies.

Trainee nurse: Oh! How is that?

Resident: The risk of stroke in children is higher in the first year of life and during the perinatal period, that is, the period right before birth and immediately after birth. Trainee: But then the common knowledge is that stroke occurs mainly among older people.

Resident: That’s right. But stroke remains among the top 10 causes of death in children.

Trainee: So what are the risk factors?

Resident: Among the common risk factors are congenital heart defects, immune disorders, diseases of the arteries, abnormal blood clotting, head or neck trauma, maternal infection in the fluid surrounding an unborn baby, premature rupture of membrane during pregnancy and pregnancy related high blood pressure in the mother.

Trainee: But newborn babies and children cannot communicate. So how can we detect the signs and symptoms of stroke then?

Resident: You’re right. Actually, we refer to what we know about stroke in adults to identify stroke in children. But there are some symptoms that you should look for specifically in children.

Trainee: Like what?

Resident: In newborns and infants, the signs are usually seizures, extreme sleepiness and hemiplegia, that is, weakness on one side of the body. And in children and teens, you should be careful about severe headaches, vomiting, sleepiness, dizziness and the loss of balance or coordination.

Trainee: And is there any treatment for this? condition?

Resident: Actually, it depends on the specific cause. Some common treatments that are used with adults are not appropriate for infants and young children.

Trainee: But what about rehabilitation methods?

Resident: It is not clear whether rehabilitation methods for pediatric stroke survivors work.

Trainee: But then again, I mean, since the symptoms might be those of adults, the treatment might be the same?

Resident: There are current treatments specific for pediatric stroke, which include supportive care to maintain normal body temperature, proper hydration, controlling high blood pressure, detecting and treating seizures with electro-encephalogram monitoring and anticonvulsant medication, managing intracranial pressure, antithrombotic therapy, which refers to medications used to prevent blood clots from forming or growing, is used in children but generally not infants, and surgery related to hemorrhagic stroke (and less commonly, ischemic stroke) is sometimes performed to relieve pressure on the brain.

Trainee: I hope that I’ll be able to spot in time a stroke in an infant or a child ! Thanks for your time.