Childhood Stroke

A stroke is when blood can’t get to all parts of your brain.

Blood carries oxygen and nutrients for your brain cells. Blood flows through your blood vessels – your arteries and veins. If blood can’t get through, your brain can be injured.

Stroke can happen at any age, but is relatively rare among children. Around 300 to 500 babies and children will have a stroke each year in Australia.

Perinatal stroke happens before birth or shortly after birth, between 28 weeks of pregnancy and one month old.

Childhood stroke occurs in a child aged from one month to eighteen years old.

Types of stroke

There are three main types of stroke:

• Ischaemic stroke is caused by an artery being blocked. It’s also called arterial ischaemic stroke (AIS).
• Haemorrhagic stroke is caused by bleeding when an artery breaks.
• Cerebral sinovenous thrombosis is caused by a blood clot in the vein.

Stroke signs

Babies

• Seizures.
• Extreme sleepiness.

In babies, there may not be signs while the stroke is happening. You may notice changes in the way your baby develops over time, such as a tendency to use only one side of their body.

Toddlers, children and teenagers

• Weakness or numbness in the face, arm or leg, especially on one side.
• Difficulty speaking, understanding, reading or writing.
• Trouble seeing or loss of vision.
• Dizziness, loss of balance or poor coordination.
• Severe or unusual headaches, nausea or vomiting.
• Difficulty swallowing, including drooling.
• Seizures with weakness that doesn’t improve.
• Changes in behaviour and difficulty concentrating.
• Stroke can sometimes cause children to collapse.

If you notice any of these signs, call triple zero (000) immediately. Even if you aren’t sure, or the signs only last for a few minutes, call triple zero (000).

If your child has had a stroke, talk with your child’s doctors about the signs you need to be aware of. Pass this information on to family, friends, childcare, kindergarten and school.

Causes of stroke

Many parents worry that they caused their child’s stroke. This isn’t the case.

Perinatal stroke (before or shortly after birth)

• Pregnancy complications.
• Difficulties during birth.
• Infections.
• Blood clotting disorders.
• Heart problems increase the risk of stroke.

Childhood stroke (one month old to 18 years old)

Problems with the brain’s blood vessels can increase the risk of stroke.

• Vasculitis can cause a blood vessel to become narrow or weak.
• Focal Cerebral Arteriopathy (FCA) can cause blood vessels to become narrow.
• Head or neck trauma can cause a blood clot to form, or cause blood to leak from a blood vessel.
• Moyamoya disease can cause blood vessels to become narrow and blocked.
• An arteriovenous malformation (AVM) is a tangled mass of blood vessels in the brain that can burst.
• An aneurysm is a weak or thin spot on an artery wall that can burst.
• A cavernous malformation is a cluster of abnormal blood vessels in the brain that can leak.

Problems with the heart or heart surgery can increase the risk of stroke. Blood clotting or other disorders can also increase the risk.

How can stroke affect children?

The effects of stroke are different for every child. How the stroke affects your child depends on the area of their brain that was injured and how badly.

Your child’s brain controls everything they think, feel, say and do. Stroke can affect:

• Walking and moving.
• Swallowing.
• Speaking, understanding, reading, writing.
• Thinking, memory, judgement.
• Personality, behaviour, emotions.
• Vision, touch, taste, smell.
• Toileting.

Children can experience pain and fatigue after a stroke. Recurrent seizures or fits (epilepsy) can develop.
Effects may be minor or they may be more serious. Effects may become more obvious as your child develops. Effects can also improve over time.

Tests and treatment

Tests include brain scans, heart tests and blood tests.

Treatment is given to minimise the injury to the brain and the risk of another stroke. Your child’s doctor will talk with you about whether treatment is appropriate and safe for your child.

Ischaemic stroke. There are early treatments for stroke that can unblock the artery so the blood can get through. Surgery may be needed to relieve the pressure caused by swelling in the brain.

Haemorrhagic stroke. Surgery may be needed to:

• Repair the damaged artery and stop the bleeding.
• Relieve the pressure caused by the buildup of blood.
• Seal or remove an aneurysm or an arteriovenous malformation.

Early intervention and rehabilitation

After a stroke, children need access to therapy to support their development and recovery. Therapies may include physiotherapy, speech therapy, occupational therapy and psychology. Therapy should begin as soon as possible after your child’s stroke.

Early intervention is for babies and very young children. Rehabilitation is for older children.

If your child is in hospital after their stroke, therapy will begin there. After that, therapy options depend on what’s best for your child and what’s available in your area.

Children’s rehabilitation services exist in each state and are linked with the major children’s hospitals.
Your child may be eligible for therapy and support from the National Disability Insurance Scheme (NDIS).

Childcare, kinder and school

Therapy teams play a key role when your child is ready to start or return to childcare, kinder or school. They help ensure your child’s carers and teachers understand your child’s stroke and are prepared.

A neuropsychology assessment can help identify educational, emotional, social and other needs.

Your child may need more help with schoolwork, equipment or reduced hours at school. The impact of stroke can change over time, as can the supports needed.

Where to get help

If you notice any of the signs of stroke, call triple zero (000) immediately. Even if you aren’t sure, or the signs go away, call triple zero (000).

• Your GP (doctor), early intervention or rehabilitation team.
• Our Family’s Stroke Journey is a comprehensive guide for parents and carers. If you would like a printed copy, please contact StrokeLine.
• StrokeLine’s health professionals provide information and advice on stroke prevention, treatment and recovery. Call StrokeLine 1800 787 653 or email strokeline@strokefoundation.org.au
• Little Stroke Warriors Australia is a positive and supportive community of families and survivors of childhood stroke.