Strokes in children

Although strokes in children are rare, they’re just as serious as those in adults. At Advocate Children’s Hospital, we provide emergency treatment to stop a stroke as quickly as possible.

Our pediatric neurosurgery teams provide the latest treatments to help prevent future strokes. We also provide physical rehabilitation to get your child back to an active life.

What is a stroke?

A stroke happens when blood flow to part of the brain is interrupted, causing brain cells to die. While strokes in children are rare, they can quickly lead to brain damage or even death, just as in adults. A pediatric stroke is a medical emergency that requires immediate treatment.

Strokes can happen at any age, even before birth. Strokes that occur before birth are referred to as fetal strokes. Strokes that occur in the first 28 days after birth are called neonatal strokes.

What causes stroke in children?

Some causes of pediatric strokes differ from causes in adults. Factors that can increase a child’s risk of stroke include:

• Blood clotting disorders
• Blood vessel problems such as moyamoya disease, aneurysms and arteriovenous malformations (AVMs)
• Congenital heart disease present at birth, such as heart valve problems or a septal defect (hole in the heart)
• Infections such as sepsis or meningitis
• Sickle cell disease
• Head trauma such as injuries or complicated labor and delivery

Stroke symptoms in children

If your child experiences any stroke symptoms, it’s critical that you seek emergency medical attention right away. Every minute counts.

In newborns and infants, symptoms of a stroke might be hard to notice. Signs to look for include

• Weakness or less movement on one side of the body
• Extreme sleepiness
• Seizures

Children and teenagers experience symptoms that occur suddenly, such as:

• Weakness or numbness in the face, arm or leg, usually on one side
• Difficulty standing, walking or moving one side of the body
• Difficulty speaking and understanding others
• Dizziness or loss of balance
• Seizures, especially affecting one side
• Severe headache that may occur with sleepiness or vomiting
• Trouble seeing clearly, such as blurry or double vision

Stroke diagnosis in children

Our pediatric emergency team provides immediate treatment for children experiencing symptoms of stroke. The next step is a thorough evaluation with specialists from our neurology program.

The neurologist asks about your child’s symptoms, medical history and overall health, then does a physical and a neurological exam. This series of tests assesses your child’s nerve and muscle functions, including thinking, memory, balance, reflexes, motor function and sensation. Learn more about what to expect during your visit, including more about neurological exams.

Your child might need other tests to help us find the cause of the stroke. These tests may include:

• Magnetic resonance imaging (MRI): We use MRI scans to look for signs of bleeding or damage to brain tissue. We offer fast MRI, with technology that corrects for movement so your child doesn’t need anesthesia.
• Computed tomography (CT): Scanning equipment uses X-rays taken from multiple angles to create 3D images of the brain. CT can show signs of bleeding or tissue damage.
• Blood tests: Using a needle, we take a small sample of blood from your child’s arm. We test for signs of infection, inflammation in blood vessels, clotting disorders and sickle cell disease.
• Cerebral angiogram: Before a scan, the doctor injects dye into blood vessels leading to the brain, making them visible in imaging. We usually do angiograms during an MRI (magnetic resonance angiogram, or MRA). Angiograms show blood vessels in the brain so we can examine blood flow for any problems.
• Transcranial Doppler ultrasound: We use ultrasound to produce images of your child’s brain. Doppler ultrasound shows the speed and direction of blood flow in the brain.
• Lumbar puncture: We take a small sample of cerebrospinal fluid, which surrounds and protects the brain and spinal cord. We then look for signs of infection.
• Electroencephalogram (EEG): We place electrodes (small, sticky pads) on your child’s head to measure the brain’s electrical activity and look for signs of seizures.
• Pulse oximetry: We use a small device, clipped to your child’s finger, to measure how much oxygen is in the blood.

Emergency stroke treatment in children

In our emergency services departments, your child receives expert care to prevent the stroke from getting worse. Treatment options focus on ensuring blood flow to the brain and are based on the type of stroke.

Ischemic stroke

• Blood-thinning medications: Aspirin and medications such as warfarin (Coumadin®) help prevent future blood clots.
• Minimally invasive procedures: We can remove blood clots using procedures that access the brain through blood vessels, avoiding the need for open surgery. Our neurosurgeons use advanced imaging to guide catheters (thin, flexible tubes) to the clot in endovascular procedures. Read more about our pediatric neurosurgery program.

Hemorrhagic stroke

• Minimally invasive procedures: Using image-guided endovascular procedures, we repair aneurysms, remove AVMs and treat other causes of bleeding in the brain.
• Surgery: Our neurosurgeons use open techniques, such as craniotomy, to treat many causes of bleeding in the brain.

Ongoing treatment for stroke in children

Our neurologists provide a customized treatment plan to help your child recover after stroke. Depending on your child’s needs, the plan may include one or more options:

• Medications: Some medications stop seizures caused by any type of stroke. Blood thinners help prevent future blood clots after ischemic stroke.
• Rehabilitation therapy: We may refer your child for physical and occupational therapy. Our skilled therapists guide your child through exercises to improve strength, flexibility and other skills.