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.
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How do you test for childhood stroke?
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. This check can sound scary, but rest assured it is not painful for the child.
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.
Blood tests are used to check for any infections or blood clotting disorders.
It's important to know that for some children there may never be a clear cause or it may take a long time to be determined.
What treatment may 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 that uses a drug to break up the clot. Thrombectomy is a treatment that 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 (see under Risk factors for ischaemic stroke in children), revascularisation surgery can help improve blood flow to the brain.
What questions should I ask medical staff?
You may find these 'questions to ask' forms useful when meeting medical staff.
- Questions to ask at neurology appointments.
- Questions to ask when looking for therapy services or attending therapy appointments.