Stroke: Its Youngest Victims


ORLANDO, Fla. (Ivanhoe Newswire) — The risk of having a stroke doubles every ten years after the age 55. However, that doesn’t mean strokes cannot happen in children, or even babies. Here are details why a stroke still remains one of the top ten leading causes of death for children.

There are two periods in your lifetime when you may have an increased risk for a stroke.

“One is around the time of your delivery and the other is the stroke most people know about which is for older people with primarily cardiovascular or vascular problems,” said James Baumgartner, M.D., a pediatric neurosurgeon at Florida Hospital in Orlando, Florida.

In both of these cases, chances of stroke-associated death or disability are increased. While high blood pressure and a hardening of the arteries are risk factors for adult strokes, the risk factors for strokes in babies include, heart defects, abnormal blood clotting, maternal history of infertility, premature rupture of the membrane, and pregnancy-related high blood pressure in the mother.

Of the babies who do survive a stroke, 50 to 80 percent of them will have a permanent disability, such as seizures or vision loss. Also “Kids that have perinatal stroke many of them get cerebral palsy,” said Dr. Baumgartner.

So what can be done? The American Stroke Association said strokes in young children are very hard to prevent, but parents and doctors can take steps in reducing the chances of another stroke by recognizing and diagnosing the underlying issues for the first stroke.

The chances of a child having a stroke are highest, a couple of days before delivery and a few days afterwards. Twenty percent of children who had a stroke will have another one.

Contributors to this news report include: Milvionne Chery, Producer; Roque Correa, Editor.

REPORT #2432

BACKGROUND:  When people think of strokes, they usually think of an older adult who probably has other health issues. But there are other victims of strokes who are just beginning their lives. Perinatal strokes happen to babies from 28 days before birth, to 28 days after birth. Perinatal arterial ischemic stroke is the most common known cause of cerebral palsy in term and near-term infants.  Perinatal stroke is seventeen times more common than pediatric stroke beyond the newborn period.  Arterial ischemia occurring during the 3 days surrounding birth is reported to be responsible for 50% to 70% of congenital hemiplegic cerebral palsy. Risk factors include cardiac disorders such as congenital heart disease, patent ductus arteriosus, and pulmonary valve atresia. Blood Disorders are another risk factor, due to deficiencies or mutations in coagulation factors and hyperviscocity syndromes which make an infant’s blood more likely to clot or hemorrhage.  Infection leads to a hypercoagulable state and has been found to be a risk factor for cerebrovascular disease. Maternal disorders including autoimmune disorders, coagulation disorders, anticardiolipin antibodies, twin to twin transfusion syndrome, in utero cocaine exposure and infection. The list continues with placental disorders including placental thrombosis, placental abruption, placental infection, and fetomaternal hemorrhage, Vasculopathy including vascular mal-development, trauma and catheterization procedures, birth asphyxia, and dehydration. Even though a risk factor may be identified, this does not necessarily mean that the risk factor is what caused the stroke.


LONG-TERM ISSUES: Obviously all parents would do anything to prevent a stroke in their newborn, but unfortunately it is not possible to identify mothers or children at risk. As a result, there are no preventative measures that could have been taken. No factors have been identified within the current standards of prenatal or obstetrical care that could be changed to try and prevent perinatal strokes. Most children with perinatal stroke suffer at least one long term challenge. Fortunately, most children avoid most of the different difficulties and many children function extremely well and lead what most would consider very normal and healthy lives. Issues children may have are motor or movement problems, difficulties learning, language issues, behavior problems (such as ADHD), partial loss of vision, or epilepsy. The onset of seizures can occur at any age.


NEW TREATMENTS: New treatments for perinatal strokes are being studied, one of the newest and most experimental forms of treatment being hypothermia. While it sounds strange, the serious drop in temperatures keeps the infant’s brain and body from overheating and reacting to the increased flow in blood. Another experimental treatment is Hyperbaric Oxygen Therapy: by putting a child in an environment of 100% oxygen, the important gas floods the body, keeping the blood and the brain from overreacting to oxygen deprivation, sometimes preventing permanent brain damage. If your doctor prefers to stay away from experimental forms of treatment, there are other anticoagulant treatments, such as heparin and urokinase.


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