There are over 400 childhood strokes a year in the UK. A stroke occurring at any time from 29 days old up to the age of 18 is classed as a childhood stroke. The causes and the effects of a stroke are likely to be different depending on how old the child is.

Causes

A stroke happens when the blood supply to part of the brain is cut off. There are two main types of stroke:

  • Ischaemic strokes are caused by a blockage in the blood supply to the brain. 
  • Haemorrhagic strokes occur when blood leaks from a burst blood vessel into the brain.

Both types of stroke are equally common in children, but in adults 85% of strokes are ischaemic. 

Children can also have a transient ischaemic attack (TIA), which happens when the brain's blood supply is interrupted for a very brief time. The symptoms only last for a few minutes or hours and then completely disappear, usually within 24 hours. 

Stroke in babies during pregnancy to within 28 days after birth can be caused by clots breaking off from the placenta and lodging in the child’s brain, or because of a blood clotting disorder that the mother or baby may have.

Strokes in children from 29 days to 18 years old are associated with existing conditions, most commonly congenital heart disease and sickle cell disease (SCD). Other risk factors are:

  • infectious diseases
  • trauma to the head or neck
  • vascular problems
  • blood disorders.

In many cases of childhood stroke, there's more than one risk factor. Stroke can also affect previously healthy children and in some cases, there can be no apparent cause.

In about 10% of childhood stroke cases, the cause is unknown.

Diagnosis

Stroke is a medical emergency and you must call 999 immediately if your child is displaying stroke-like symptoms. At the hospital, your child should see a consultant paediatrician, neurosurgeon or paediatric neurologist.

A brain scan should take place as soon as possible to confirm whether your child has had a stroke. There are two types of scans: CT and MRI.

An MRI scan is preferable as it shows a more detailed image of the affected area and blood vessels within the brain. This should last an hour and requires your child lying still while the machine takes a picture of their brain. Your child may be given a sedative to help keep them still. If an MRI scan isn't available, a CT scan is a good alternative.

Blood tests might be taken to check for any infections, chemical problems or clotting disorders that may have caused the stroke. 

Treatment

Once the doctor knows what type of stroke the child has had, they'll be able to decide the best treatment. If the stroke was caused by a blockage, long-term blood-thinning medication, like aspirin, may be prescribed to help prevent another stroke from happening. 

If your child has SCD, they'll have an urgent blood transfusion. The transfusion will help replace the sickled red blood cells in your child's body with normal blood cells. 

Once your child is well enough, rehabilitation should begin. Many people believe children fully recover after stroke because their brain is still developing but it's more accurate to say that children are better at adapting to the effects of stroke. 

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