Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
Monroe Carell Jr. Children's Hospital at Vanderbilt
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Monroe Carell Jr.
Children's Hospital
at Vanderbilt
2200 Children's Way
Nashville, TN 37232


(615) 936-1000

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Pediatric Strokes

 

Common causes of stroke in children include:

  1. Conditions that affect blood vessel of the head and neck including: arterial dissections, moyamoya disease, arteriopathy, arteriovenous malformations (AVM), cerebral cavernous malformations and aneurysms
  2. Blood clotting problems - both easy clotting or “thrombophilia” and easy bleeding.
  3. Problems with the heart: including congenital heart defects or problems with heart function such as cardiomyopathy.

What is stroke?
About three out of every 100,000 children will have a stroke before the age of 18. In newborns, 25 out of every 100,000 have a stroke. Perinatal stroke is the term used when a stroke happens before birth or within 28 days of birth. A stroke is a brain injury that happens when blood flow to part of the brain is disrupted. The brain needs oxygen to survive. When blood is not flowing properly, brain cells do not get oxygen and they begin to die, which is what causes the symptoms associated with the stroke.

There are two main types of stroke: 

Ischemic - when blood flow to part of the brain is insufficient

Hemorrhagic - bleeding within or around the brain

These two types of stroke can be caused by many factors. Ischemic stroke is typically caused by blocked blood flow to an artery or by narrow/small blood vessels limiting blood supply to the brain. Hemorrhagic stroke is most often caused by weak or abnormally formed blood vessels or blood clotting abnormalities. A transient ischemic attack (TIA), "mini-stroke," causes a stroke-like symptom, such as weakness on one side of the body or trouble speaking, that goes away quickly. If you have had a TIA, a brain MRI will not show signs of a stroke, but a TIA can be a warning sign that a bigger stroke may occur.

Common signs and symptoms of stroke

Speech Impairment


  • Garbled

  • Slurred

  • Inability to speak (partially or fully)

Hemiparesis


  • Weakness of face, arm, and/or leg on one side
  • 
Numbness might also be associated

Impaired Movement


  • Unsteady walking (gait)
  • 
Inability to fully reach or grab objects

Vision Impairment

  • 
Double vision
  • 
Loss of vision to one side

  • Complete vision loss

  • Abnormal eye movements

Altered Mental Status


  • Diminished comprehension
  • 
Change in consciousness with other neurologic abnormalities like headache, nausea, and/or vomiting

New Onset Focal Seizures

  • 
Typically seen in newborns

Call 911 if you think your child may be having a stroke.

How is stroke diagnosed?

The Vanderbilt Pediatric Acute Stroke Team includes physicians and nurses from the Pediatric Emergency Department, Neurology, Radiology, Hematology, Cardiology, and Critical Care Medicine. Our team approach allows for fast evaluation of children who may have had a stroke. Learn more about our emergency rapid response protocol.

A thorough physical exam, including a neurological exam, is used to find out how your child's brain is working. Blood tests are needed to look for underlying blood problems that may cause a stroke. Images of your child's brain using a MRI or CT scanner will help diagnose stroke. Doctors may also request pictures of your child's blood vessels via a MRA, CTA, and/or cerebral angiography.

How is stroke treated?
Doctors will provide treatments that may be able to reduce the size of your child's stroke and improve some of your child's symptoms. Your doctors will also try to determine what caused your child's stroke and treat the underlying condition.

They can also help manage risk factors to reduce the chance your child will have another stroke. For example, if your child has a blood disorder that makes their blood clot too easily, doctors may give your child a medicine like aspirin to keep blood from sticking to itself. If your child's stroke was caused by a physical problem such as abnormal blood vessels, doctors may be able to do surgery to reduce the chance of additional strokes.

At Monroe Carell Jr. Children's Hospital at Vanderbilt, we are experts at diagnosing and treating children with stroke. Through our multidisciplinary center, we provide resources for comprehensive treatment, long-term follow-up and support for patients and families.


Last Edited: December 9, 2014
Valued Participant of Vanderbilt Health Affiliated Network