Stories about: pediatric stroke

Stroke in kids: What’s different?

pediatric stroke
Illustration: Fawn Gracey

Every May, we recognize National Stroke Awareness Month to honor everyone who has experienced a stroke — and to raise awareness of this disease. That awareness is especially important for pediatric stroke, which is more common than you might imagine. “Stroke occurs throughout childhood, from birth through 18 years of age, and more commonly than people think,” says Dr. Michael Rivkin, co-director of the Stroke and Cerebrovascular Center at Boston Children’s Hospital. “In fact, among newborns, its occurrence is very nearly that of its occurrence in older adults.” Here, he shares four facts parents need to know about pediatric stroke — and how it differs from that in adults.

No1
Kids aren’t immune.

Despite the misconception that stroke is a disease of the elderly, anyone can experience one — including infants and children. Babies can even have strokes while they are still in their mother’s womb. All told, strokes occur in an estimated 1 in 2,500 live births and affect nearly 11 out of 100,000 children under age 18 every year. The risk of having one is highest in a child’s first year of life, particularly during the few weeks before and after birth.

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Kids can have different risk factors.

Most of us are familiar with the factors that can raise the risk of stroke in adults, such as cardiovascular disease, an irregular heartbeat, obesity, diabetes and smoking. But children are more likely to experience a stroke for different reasons, says Dr. Rivkin. Common risk factors for pediatric stroke include congenital heart disease, blood vessel abnormalities (such as arterial dissection and moyamoya), disorders that increase the blood’s tendency to clot (such as sickle cell disease), infection or inflammation.

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Kids can have different symptoms.

In adults, we’ve been taught to look for the most common warning signs — classic symptoms such as facial drooping, arm weakness or numbness and speech difficulties. Although these signs can also be used to help identify the problem in children, kids can exhibit other symptoms as well. Newborns and young children may be extremely sleepy, use only one side of their body and experience seizures. In children and teenagers, severe headaches, vomiting, dizziness and trouble with balance and coordination, as well as seizures, may signal a stroke.

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Kids tend to recover better.

Because children’s brains are still developing, they tend to recover better than many adults. Indeed, the problems that result from the stroke (such as weakness and numbness) can often improve over time with therapy. A team approach to pediatric stroke — including child neurologists, hematologists, neurosurgeons, interventional and neuroradiologists, physical and occupational therapists, speech and language therapists, neuropsychologists, educational specialists, and physical and rehabilitation medicine physicians — is optimal. “We understand that a multidisciplinary and intensive approach to care of children with stroke provides the best route to recovery,” says Dr. Rivkin.

Learn about the Stroke and Cerebrovascular Center.

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Michelle is moving ahead after experiencing a stroke

pediatric stroke

In fall of 2014, I was a senior, excited about finishing high school in New Hampshire and heading off to college. But I could never have guessed what the year would bring. I was an avid lacrosse player and competing in my fifth game of a tournament when I started to notice I was having trouble seeing out of my left eye. Soon, my hand felt weird and I couldn’t grip the stick properly. As I sat on the sidelines, onlookers recommended I be taken to a local hospital.

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Keeping up with Amanda: Life after brain surgery

Amanda LePage is now a happy 9-year-old.In most ways, Amanda LePage is just like any other rambunctious fourth grader. She loves school, dance class, playing basketball and keeping up with her twin sister Macy and older brother Nathan. Sometimes it just takes her a little longer to do these everyday things. That’s because Amanda has been through a lot in her short nine years.

Amanda was just 5 months old when she was brought by helicopter to Boston Children’s Hospital for a hemorrhage in her brain from an intracranial aneurysm, a type of vascular malformation. Despite long odds, Amanda survived two life-saving brain surgeries and a massive stroke that left her with cognitive delays, no use of her left arm or hand, and weakness in her left leg.

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Doctor-patient friendship helps make an upside-down world right

pediatric strokeSeven-year-old Jacob Downing has a list of caregivers as long as his “different” right arm.

On top on the list is a be-spectacled, bow-tie-wearing neurologist. Dr. Michael Rivkin is co-director of the Boston Children’s Hospital Stroke and Cerebrovascular Center and the first person Jacob remembers seeing after the emergency surgery he underwent following a stroke.

Jacob doesn’t remember the surgery to clear the blood clot that caused his stroke. “Dr. [Darren] Orbach worked a miracle for him,” says Jacob’s mother Nichole. Orbach is the neurointerventionalist who performed the endovascular thrombectomy procedure to break up the blood clot that caused his stroke.

“Like a lot of doctors at Boston Children’s, Dr. Rivkin talks directly to Jacob. Jacob knows he is trying to help him, and it shows,” says his father Justin.

And Jacob has needed a lot of help in the aftermath of his stroke. Initially, he seemed to quickly regain some of his lost skills.

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