On this page you can find information about the different symptoms of stroke in children and babies, and how childhood strokes are diagnosed and treated.
The information on this page can be accessed in the following formats:
Diagnosing stroke in children
The FAST test can be used to identify strokes in children:
- Face: Can the young person smile? Has their face fallen on one side?
- Arms: Can they raise both arms and keep them there?
- Speech: Can they speak clearly and understand what you say? Is their speech slurred?
- Time: If you see any one of these three signs, it’s time to call 999.
However, children and young people may also have other symptoms including:
- Sudden, severe headache.
- Seizures (fits).
- New and sudden vertigo or dizziness, neck pain or stiffness.
- Nausea/vomiting, fever or loss of consciousness.
- Sudden blurred vision or loss of sight in both eyes.
- Weakness or numbness on one side of the body.
- Changes in sensation, like pins and needles in arms or legs.
In babies up to 28 days old, seizures are a common symptom of stroke. It may also be the case that a stroke in a baby is only identified later, when problems arise with their learning and development. They may have difficulties with movement on one side, known as hemiplegia.
It is important to remember that stroke symptoms that last a short amount of time can be a transient ischaemic attack (TIA or mini-stroke). In a TIA, a blood vessel in the brain gets blocked, but the blockage clears by itself. A TIA is a major warning sign of a stroke, and you should call 999.
A brain scan should take place within an hour. The type of scan used might be a magnetic resonance imaging (MRI) or computed tomography (CT). The scans show the affected area of the brain and the blood vessels in the brain. Your child may need a sedative to help them keep still. If your child becomes very sleepy and the doctors are concerned about their levels of consciousness, they will have an urgent brain scan even if they have already had one scan.
An echocardiogram uses ultrasound to look at the heart and surrounding blood vessels. Children with sickle cell disease have a transcranial Doppler test, which uses ultrasound to check the rate of blood flow through the arteries.
Angiography uses X-rays to look for problems with blood vessels in an area such as the brain or heart.
Looking for the cause
Your child’s medical history may also provide clues as to the cause of the stroke, such as having sickle cell disease or congenital heart disease.
What treatment will my child have?
If the stroke is due to a clot (ischaemic stroke), your child may be given blood-thinning medication such as aspirin to prevent another stroke. A small proportion of children may be eligible for treatments to remove a clot. Thrombolysis is a clot-busting treatment which uses a drug to break up the clot. Thrombectomy is a treatment which physically removes a clot using a retrieval device.
Both treatments need to happen within hours of the stroke, and the child needs to meet strict criteria about their stroke and other health conditions. In some cases, doctors will undertake neurosurgery to help ease pressure building up in the brain.
Treatment for sickle cell disease (SCD)
Children with sickle cell disease are not usually given blood thinning medication. They will be given an urgent blood transfusion, and they should be seen by a paediatric haematologist. After the stroke, your child should be monitored to check for any signs of cognitive problems and changes to the blood flow in the brain.
To treat the sickle cell anaemia and reduce the chance of another stroke, your child may need regular blood transfusions. Stem cell transplants can sometimes be used to treat sickle cell disease, but this does not happen very often due to the risks involved in the transplant.
Treatment for Moyamoya syndrome
If a stroke was due to moyamoya syndrome, revascularisation surgery can help improve blood flow to the brain.