How to recognize stroke in kids

Published: Sep. 10, 2018 at 2:04 PM EDT
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When blood flow to the brain is blocked due to a clot, it can trigger a lethal stroke.

Although most strokes are limited to older individuals, it's the sixth leading cause of death in children.

When 15-year-old John Beveridge suddenly passed out on the football field, coaches and players rushed to his side to help.

The reason for his sudden illness was something no one saw coming.

“I wasn’t feeling that great, then I was kinda feeling fine, so I went outside to do a lap, and just like that, I was out and I woke up on the ground,” John explains.

He had suffered a cerebral stroke.

“I had no clue what had happened to me. I was so confused. I thought it was dehydration,” he admits.

It turns out that a mitral valve heart tumor had triggered the stroke. This fibrous tumor is mobile because it’s pulled in and out of the heart chamber by blood flow.

“We know that if you see something in the heart and the patient has had a stroke, you can surmise that a little piece of it has broken off and gone to the brain,” explains Meryl S. Cohen, MD, a professor of pediatrics at the University of Pennsylvania.

Fortunately the tissue from the fibrous tumor was removed before it could do more damage.

“After about a half-hour, they determined that it went down, thank God, instead of another piece going to his brain and causing a massive stroke,” explains John's dad, Rob Beveridge.

Even though he knows he dodged a bullet, John was back to normal before long.

“It took me six weeks after, I was back in the gym, almost back to my routine,” John says.

“It was a weight off our shoulders. What a relief, knowing that he had a great outcome and great surgery and knowing that he was gonna be fine,” John's dad says.

The risk of stroke in children is 11 in 100,000 per year.

In some cases, the cause is sickle cell disease, immune disorders or a heart defect, as with John.

Although strokes in kids aren’t common, parents are advised to be concerned if a teen suffers severe headaches, dizziness or extreme sleepiness.




REPORT: MB #4466

BACKGROUND: Stroke is often referred to as a “brain attack.” It occurs when blood flow to an area of the brain is cut off. There are many causes of stroke in children, and they are often not well understood. Diagnosis requires careful clinical examination combined with brain imaging. Early treatment focuses on protecting the brain and keeping blood vessels open to prevent more strokes. Many children experience neurologic deficits with long-term treatments focused on physical, developmental, and psychosocial complications. The study of pediatric stroke has been growing rapidly, from understanding the main causes to supporting children and families.


CAUSES: Identifying pediatric stroke and finding the cause of a stroke is vital to providing the right treatment and preventing more injury. Doctors can find a cause in about two thirds of the cases. A common cause of ischemic strokes is a blood clot that forms in the heart and travels to the brain. This can be caused by congenital heart problems such as abnormal valves or infections. In these cases, children may need surgery or antibiotics. Sickle cell disease is a blood disorder that’s associated with ischemic stroke. In sickle cell disease, the blood cell can’t carry oxygen to the brain, and blood vessels leading to the brain may have narrowed or closed. About 10 percent of children with sickle cell disease suffer a stroke. There is a high risk of repeat strokes, but this can be reduced by blood transfusion.


TREATMENT: Treatment for pediatric stroke depends on the specific cause. Some common treatments used with adults are not appropriate for young children and infants. One treatment for ischemic strokes for adults is tPA, or tissue plasminogen activator, a drug that dissolves blood clots. With children under 18, use of tPA is controversial and currently limited to clinical trials. Further studies on safety and benefits of this treatment are necessary. Rehabilitation methods with pediatric stroke survivors are also not clear and require further clinical trials.