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DESCRIPTION: Stroke occurs when brain cells are damaged due
to decreased blood flow to the brain. Although stroke is a relatively frequent occurrence
in adults, it is much less common in children. However, strokes can occur in children of
all ages, from newborns to adolescents. There are 2 types of stroke, ischemic and
hemorrhagic. An ischemic stroke is caused by a blockage of a blood vessel. A hemorrhagic
stroke is caused by bleeding into the brain (also called intracerebral hemorrhage) or into
the spaces surrounding the brain (also called subarachnoid hemorrhage). Hemorrhagic stroke
in newborns is usually caused by a subarachnoid hemorrhage. The most common cause of
stroke in children is congenital heart disease. Other causes include sickle cell anemia,
intracranial infection, brain injury, vascular malformations, occlusive vascular disease,
and some genetic diseases. Symptoms of stroke in children are similar to those in adults,
with some significant differences. In children (especially those under 4 years of age)
seizures are frequently present at the onset. Other symptoms include loss of expressive
language, hemiplegia (paralysis on one side of the body), dysarthria (impairment of
speech), convulsions, headache and fever. The warning signs of stroke in children include
sudden weakness on one side of the body and/or a sudden loss of speech. The sooner a
stroke in a child is diagnosed the better the chance for recovery.
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TREATMENT: Treatment of stroke in children is similar to
treatment of stroke in adults. Immediate attention must be paid to any signs of increased
cranial pressure and associated illnesses which may need to be treated. The child should
be hospitalized and closely monitored. The underlying conditions which led to the stroke
must be determined and managed to prevent recurrences. Rehabilitation including physical
therapy should be initiated as the child recovers.:
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PROGNOSIS: Although the prognosis for children with stroke is
generally thought to be better than for adults--possibly due to the greater plasticity
(flexibility) of the immature brain--some children may have a poor outcome. Children who
experience seizures at onset tend to have a worse prognosis for intellectual development
and a higher incidence of subsequent seizures than children who have no seizures.
Depending on the underlying condition, some children have a residual deficit such as
epilepsy, movement disorders, hyperactive behavior, hemiplegia, learning disabilities, or
mental retardation. However, most children with residual hemiplegia will be able to walk.
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RESEARCH: The NINDS supports a broad range of basic and clinical
research aimed at finding better ways to prevent, diagnose, and treat stroke and
ultimately restore functions lost as a result of stroke.
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These articles, available from a medical library, may provide
more in-depth information on stroke in children:
Allan, W, and Riviello, Jr., J. "Perinatal Cerebrovascular Disease in the
Neonate." Pediatric Neurology, 39:4; 621-650 (August 1992).
Horwitz, S, and Wiznitzer, M. "Stroke in Childhood." In Neurology in Clinical
Practice: Principles of Diagnosis and Management, Butterworth-Heinemann, Boston, pp.
979-982 (1991).
Pavlakis, S, Gould, R, and Zito, J. "Stroke in Children." Advances in
Pediatrics, 38; 151-179 (1991).
Trescher, W. "Ischemic Stroke Syndromes in Childhood." Pediatric Annals,
21:6; 374-383 (June 1992).
Information may also be available from the following organizations (last updated
April 7, 1998):
National Stroke Association
96 Inverness Drive East, Suite 1
Englewood, CO 80112-5112
(303) 649-9299
(800) 787-6537
National Rehabilitation Information Center
8455 Colesville Road, Suite 935
Silver Spring, MD 20910-3319
(800) 346-2742
Institute for Health and Disability
University of Minnesota, Box 721
420 Delaware Street, SE
Minneapolis, MN 55455-0392
(612) 626-2825
National Institute on Deafness and Other Communication Disorders
Building 31, Room 3C35
Bethesda, MD 20892-2320
(301) 496-7243
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National Institute of Neurological Disorders and Stroke
National Institutes of Health
Bethesda, MD 20892
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