Top Things to Know: Management of Stroke in Infants and Children
Published: July 17, 2008
- National Hospital discharge Survey reports from 1980-1998 indicate that the overall stroke risk in individuals from birth to 18 years is 7.8/100,000, with the hemorrhagic stroke risk at 2.9/100,000.
- About a half of children presenting with a focal neurological deficit have a previously identified risk factor. In the other half, one or more additional risk factors are often discovered
- For arterial stroke the most common underlying conditions are sickle cell disease (SCD) and congenital or acquired heart disease.
- Risk factors for stroke in children include congenital heart disease, sickle cell disease, infections, and prothrombotic states (formation of blood clots).
- In sickle cell disease, the use of Transcranial Doppler can help define those children that are at high risk of stroke.
- The clinical presentation of stroke in neonates in both arterial and venous strokes often present with seizures (focal motor seizures affecting one extremity).
- Recommendations for prevention of stroke in SCD are given and include periodic blood transfusions to reduce the percentage of sickle hemoglobin, in children 2-10 years old with abnormal TCD results due to SCD.
- Antiplatelet therapy such as aspirin can be used in children, recommendations are given.
- Protocols for warfarin and heparin are also described in this paper.
- Age-appropriate rehabilitation after stroke in children is recommended, as well as psychological assessments for cognitive and language disorders.