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A stroke is a brain injury caused by the interruption of blood flow to part of the brain. Blood carries oxygen, nutrients and other important substances to the body’s cells and organs, including the brain.

There are two different types of stroke: ischemic and hemorrhagic. Ischemic strokes occur when the blood supply is disrupted due to a clot or narrowing of the blood vessels. Hemorrhagic strokes occur when the bloody supply is disrupted due to bleeding in the brain. In children, approximately 50% of strokes are ischemic and 50% are hemorrhagic. A transient ischemic attack (TIA) is a temporary disruption of blood flow that does not cause permanent damage to the brain tissue or permanent disability.

What Causes Strokes in Children?

Finding the cause of a pediatric stroke in children can be difficult. Common causes of stroke in children differ from those in adults.

Some common causes of ischemic stroke in children include:

• Congenital heart disease: patients with congenital heart disease have a higher risk of developing blood clots in the heart that may then travel to the brain, causing a stroke.
• Problems with blood vessels in the brain (also called arteriopathies): this may be caused by an infection, the reaction of the body to an infection, trauma or an underlying disease of the blood vessels such as moyamoya disease.
• Sickle Cell Disease or other blood disorders.
• Autoimmune diseases.

Common causes of hemorrhagic strokes in children include:

• Head injuries/trauma.
• Blood vessel abnormalities (dissection, vasculitis, abnormally formed blood vessels).
• Blood clotting diseases.

Risk of Stroke in Kids

The risk of stroke in kids is highest before the age of 1. A stroke is much more common in adults than in children. Because strokes aren’t as common in children as they are in adults, a diagnosis may be delayed. Children, however, often recover more easily than adults because their brains are still developing and are more adaptable to change.

Symptoms of Stroke in Children

Symptoms of strokes in children depend on the age of the child and the cause of the stroke. Below are some common signs of a stroke in infants, kids and teens.

Common Signs of a Stroke in Infants

Perinatal strokes may occur from the middle of the pregnancy, through the birth period and up until 28 days after the baby is born. In some cases, infants with perinatal stroke develop normally but at a slower pace than other kids. They also might tend to use one hand more than the other. In other cases, there are symptoms of stroke that occur during the newborn period. Symptoms in infants and newborns could include:

• Seizures: this can manifest as repetitive involuntary jerking of the face, arm or leg, staring spells or periods in which baby stops breathing and turns blue.
• Extreme fatigue, difficulty waking up or poor feeding.
• Often there are no signs in the newborn period, but around 4-6 months old, parents or the primary care doctor may notice the baby is weaker on one side of the body, has a major hand preference before 1 year of age or is not meeting developmental milestones as expected.

Common Signs of a Stroke in Kids and Teens

Signs of stroke in children usually start suddenly. They may include:

• Weakness or loss of sensation on one side of the body or face
• Vision changes
• Inability to speak clearly or understand
• Balance problems
• Severe headache (especially with vomiting or sleepiness)
• New seizures (usually affecting one side of the body)