The Stroke's Childish Impact: A Brain's Regression

A stroke is a life-threatening condition that occurs when blood flow to the brain is blocked or interrupted, causing brain cells to die and resulting in brain damage. While strokes are more commonly associated with adults, they can also occur in children and even infants. The effects of a stroke on a child can vary, but in some cases, it may lead to long-term cognitive and developmental issues that can cause child-like behaviours. Early intervention and treatment are crucial to minimizing the impact and maximizing the chances of recovery.

A stroke can cause seizures, paralysis, and weakness on one side of the body

Seizures

Post-stroke seizures are most common in the first few days after a stroke but can occur at any time. They are usually an indication that the stroke was severe and caused damage to the white matter (inner layers) of the brain's cerebral cortex, disrupting electrical activity. This damage can cause disorganised electrical activity in the brain, leading to seizures.

Paralysis and Weakness on One Side of the Body

Paralysis or weakness on one side of the body is a common sign of stroke in both older children and adults. This occurs when the stroke affects one side of the brain, causing problems with movement and coordination on the opposite side of the body.

Stroke in Children

Strokes in children can occur from before birth up to 18 years of age, with risk factors including congenital heart disease, blood clotting disorders, infections, and autoimmune disorders. Signs of a stroke in older children may include sudden paralysis or weakness on one side of the body, slurred speech or difficulty speaking, vision problems, and seizures.

In infants, signs of a stroke may include seizures in one area of the body, such as an arm or leg, trouble breathing, developmental delays, and an early preference for using one hand over the other.

Treatment and Recovery

Prompt diagnosis and treatment are crucial for minimising the risk of long-term problems after a stroke. Treatment options may include medical therapy with aspirin or other blood thinners, and anti-seizure medications if necessary. Early rehabilitation can also help maximise recovery, and a child's growing brain has a better chance of recovering from a stroke than an adult's brain.

It can lead to changes in behaviour and difficulty concentrating

A stroke can lead to changes in behaviour and difficulty concentrating. This is because a stroke occurs when blood flow to the brain is blocked or interrupted, meaning brain cells are injured or die. This can cause permanent brain damage and affect a person's body in a variety of ways.

Behavioural changes and difficulty concentrating are common symptoms of a stroke in children. This is because a stroke can affect a child's brain in the areas that control personality, behaviour, emotions, thinking, memory and judgement. As a result, children may experience changes in behaviour and difficulty with concentration, memory, schoolwork and speech. They may also experience confusion, seizures, and problems with vision, balance, walking and coordination.

In babies, there may not be any signs of a stroke while it is happening. Instead, parents may notice changes in their baby's development over time, such as a tendency to use only one side of their body. In older children, signs of a stroke include weakness or numbness on one side of the body, slurred speech, and sudden lethargy or drowsiness.

It is important to recognise the signs of a stroke and seek immediate medical attention, as prompt treatment can make a big difference in a child's health and recovery.

A stroke can cause vision problems, including blurred or double vision

Strokes can happen to people of any age, from infants to teenagers and adults. They occur when a blood vessel carrying oxygen and nutrients to the brain is blocked by a clot or bursts (or ruptures). When this happens, the brain cells in that area are damaged or die due to a lack of blood and oxygen. This can have permanent effects on the body's functionality.

Strokes can cause vision problems, including blurred or double vision. Blurred vision is a common problem and can be caused by issues with any component of the eye, such as the cornea, retina, or optic nerve. It can be a result of ageing, diabetes, or the need for glasses. However, it can also be a sign of more serious health issues, including stroke.

During a stroke, the brain can be affected in the area that controls vision, resulting in blurred or lost vision in one or both eyes. This is often a sudden, painless change in eyesight and can be a key indicator of a stroke. Other symptoms that may accompany blurred vision and are indicative of a stroke include slurred speech, weakness or numbness in the arms or face, and a severe headache with no known cause.

If you or someone you know is experiencing these symptoms, it is crucial to act FAST and call emergency services immediately. Early treatment is vital and can improve the chances of survival and reduce the level of disability resulting from a stroke.

In addition to blurred vision, a stroke can also cause other vision problems. Depending on the area of the brain affected, a person may experience difficulties with walking, speaking, reading, or seeing, with one side of the body being more affected than the other.

It can cause headaches, nausea, and vomiting

A stroke can cause severe headaches, nausea, and vomiting. These symptoms are not exclusive to adults and can be exhibited by children as well. In fact, according to Johns Hopkins Medicine, pediatric stroke is a rare condition that affects one in every 4,000 newborns and an additional 2,000 older children each year.

The occurrence of a stroke in children can be due to blocked or interrupted blood flow to the brain, which can be caused by a blood clot or a broken blood vessel. This interruption in blood flow can lead to brain cell death and brain damage. The signs and symptoms of a stroke in children include weakness or numbness on one side of the body, slurred speech, difficulty balancing or walking, vision problems, seizures, and behavioral changes.

It is crucial to recognize the signs and symptoms of a pediatric stroke and seek immediate medical attention. Prompt diagnosis and treatment can minimize the risk of lasting problems, and early rehabilitation can help maximize recovery.

In addition to severe headaches, nausea, and vomiting, other symptoms exhibited by children post-stroke include:

• 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.
• Seizures with weakness that doesn't improve.
• Changes in behavior and difficulty concentrating.

It is important to note that the effects of a stroke on a child depend on the area of the brain that was injured and the severity of the injury. Some children may experience pain and fatigue after a stroke, and recurrent seizures or fits (epilepsy) can develop. These effects may become more apparent as the child develops, but they can also improve over time with rehabilitation and therapy.

Prompt action and treatment can improve outcomes and aid recovery

A stroke is a life-threatening condition that requires immediate medical attention. The quicker a stroke is treated, the more likely the person will recover without disability. Prompt action and treatment can improve outcomes and aid recovery.

Diagnosis

If a stroke is suspected, a doctor will likely request one or more of the following tests:

• Magnetic resonance imaging (MRI)
• Magnetic resonance angiography (MRA)
• Magnetic resonance venography (MRV)
• Computed tomography scan (CT or CAT scan)
• Computed tomography angiography (CTA)
• Cranial ultrasound
• Lumbar puncture (spinal tap)

Treatment

The treatment for a stroke depends on the type of stroke, the area of the brain affected, the amount of brain tissue damaged, and the presence of any ongoing conditions.

In the early stages of a stroke, treatment focuses on supporting blood flow to the brain. This may involve:

• Medical therapy: Administration of aspirin, blood thinners (anticoagulants), and special vitamins.
• Interventional neuroradiology: Placement of a catheter inside the affected blood vessel to repair abnormal areas or remove large clots.
• Surgery: Depending on the cause of the stroke, surgery may be required to remove pieces of bone, close abnormal blood vessels, remove abnormal areas of the brain, or reroute blood vessels.

Rehabilitation

Rehabilitation is a critical aspect of stroke recovery. It helps the person regain abilities they had before the stroke and adapt to any changes in their brain. Rehabilitation may include:

• Speech therapy: To improve language, speaking abilities, and control of muscles for breathing, eating, drinking, and swallowing.
• Physical therapy: To improve the use of hands, arms, feet, and legs, as well as balance issues and muscle weakness.
• Occupational therapy: To retrain the brain for daily activities, improve hand movements, and muscle control.
• Cognitive therapy: To address memory problems and difficulties with focus or concentration.

Reducing Risks and Preventing Complications

Some measures can be taken to reduce the risks of a stroke and prevent complications:

• Lowering blood pressure: As high blood pressure is a common cause of hemorrhagic strokes, lowering blood pressure can limit bleeding and facilitate clotting.
• Supporting hemostasis: Infusion of medications or blood factors to enhance the body's natural clotting ability and control bleeding, especially in those taking blood-thinning medications.
• Early supported discharge: Provided by a multidisciplinary team, this involves rehabilitation at home starting within 24 hours of discharge, aiming to improve patient outcomes, satisfaction, and reduce costs.
• Preventing deep vein thrombosis (DVT) and pulmonary embolism (PE): As these are common complications post-stroke, intermittent pneumatic compression is recommended to reduce their incidence.
• Managing bladder, bowels, and skin care: Urinary incontinence, constipation, and pressure sores are common issues post-stroke, and proper management can reduce their impact.

Overall Outcome

While stroke can have severe and lasting effects, including cognitive and motor impairments, prompt diagnosis, early treatment, and rehabilitation can significantly minimize the risk of long-term problems and maximize the chances of recovery. The growing brain of a child has a better chance of recovering from a stroke compared to an adult.

Frequently asked questions