Does your little one have a stroke? (Pediatric Stroke) Don't worry, let's be aware of this!

We have all heard that adults can have strokes . But did you know that, although very rarely, our little ones, from newborns to children under 18 years of age, can also have this condition, called a Pediatric Stroke . Even if you are a little worried when you hear this, don't worry. If you are properly informed about this, you can do the necessary things quickly.

What is Pediatric Stroke?

Simply put, a stroke is a condition that occurs when blood flow to a part of our brain is interrupted. It's like what happens when our water heater runs out of water. The brain gets its oxygen supply from blood. So if the blood flow stops, the brain cells start to die. This is a life-threatening emergency.

This can happen to adults as well as children. We call it ' Pediatric Stroke ' when it occurs in a child under the age of 18. There are also variations:

• Perinatal strokes: Some babies are born with this condition.
• Those that happen within the first 28 days of life: That is, those that happen to newborn babies.
• And then the ones that happen up until the age of 18: these are what we call 'childhood strokes'.

The causes are often heart disease, blood clotting problems, etc. Sometimes it can be caused by accidents that reduce oxygen to the brain, or by certain congenital conditions .

What are the main types of polio?

Just like adults, our little ones can experience three main types of paralysis:

• Hemorrhagic stroke: This occurs when a blood vessel in the brain bursts and bleeds. Think of it like a water pipe bursting and leaking water.
• Ischemic stroke: This is when a blood clot blocks a blood vessel in the brain, blocking blood flow. It's like a piece of dirt blocking a water pipe.
• Transient Ischemic Attack (TIA): This is like a 'mini stroke'. A blood clot gets stuck in a blood vessel in the brain for a short time, then it dislodges and blood flow returns to normal. The symptoms last for a while and then go away. But this is also a very important warning sign that a major stroke is possible.

How common is this?

In fact, stroke in children is very rare . So there is no need to be unnecessarily alarmed. According to researchers, this condition occurs in one or two out of every 100,000 children under the age of 18 each year. About one in 3,500 newborns may have a perinatal stroke . But it is difficult to give an exact figure, because sometimes it is difficult to diagnose.

What are the symptoms of polio? How can they be identified?

Some of the symptoms that adults experience when they have a stroke can also occur in younger people. These symptoms include:

• There is a sudden change in behavior or thinking .
• Hearing and vision changes occur.
• Feeling or feeling weak on one side of the body (Hemiparesis) .
• Difficulty speaking and understanding words (Aphasia) .
• Difficulty swallowing (Dysphagia) .
• When walking, it feels like you are swaying to one side and walking awkwardly (ataxia) .

Imagine, if your child suddenly slurs his words after playing, or feels like he can't move an arm or leg... In such cases, you should seek medical advice immediately.

However, very young children, especially newborns and toddlers who can't yet speak properly, may not show these obvious signs. Instead, they may see things like:

• Seizures. This is the most common symptom of paralysis in young children.
• I have a bad headache.
• Vomiting, nausea.
• Constant tiredness and sleepiness.
• Fever for no reason.

These symptoms can also be present in other illnesses, so it's hard to immediately assume it's a stroke. But if you see something like this, especially if it feels like a fit, you should definitely see a doctor.

Why do young children get paralysis? What are the causes?

A stroke usually occurs when blood flow to the brain is interrupted. This can be caused by a blood clot (ischemic stroke) or by a blood vessel bursting inside the brain (hemorrhagic stroke) .

There are several specific reasons why this condition occurs in young children:

• Certain congenital abnormalities of the blood vessels in the brain: For example , a condition called Arteriovenous Malformation (AVM) . In this condition, the blood vessels in the brain are tangled, making them more likely to burst and bleed. These are often congenital conditions.
• Congenital heart disease: Some babies are born with certain heart problems. These heart conditions can also increase the risk of stroke.
• Blood-related diseases: For example , children with a disease called Sickle Cell Disease are more likely to develop blood clots. Also, diseases that prevent blood from clotting easily (e.g. Hemophilia ) can also cause bleeding in the brain.

What are the risk factors for paralysis?

Some children may be at a slightly higher risk of developing paralysis than others. Such risk factors include:

• Heartbeat irregularities (Arrhythmias) .
• Congenital heart disease .
• Lack of oxygen to the brain at birth (Cerebral hypoxia) .
• Diabetes.
• High blood pressure.
• Obesity means being too big.
• Conditions where the blood clots easily (Thrombophilia) or conditions where the blood does not clot easily (Hemophilia) .
• Severe head or neck injuries (Traumatic Brain Injury - TBI) .
• This risk is also slightly higher for children with certain genetic conditions, for example , Down syndrome .

What are the possible complications of paralysis?

In most cases, most children who have a stroke make a full recovery. That's really good news. However, depending on which part of the brain is affected by the stroke, some children may have permanent changes.

• For example, there may be persistent weaknesses in the way we think and speak .
• There may be persistent weakness on the side of the body affected by the paralysis.
• Permanent changes in vision may also occur.
• Also, children who have had a stroke are at increased risk of developing epilepsy later in life.

That is why it is so important to seek treatment quickly and properly engage in rehabilitation programs.

How is polio diagnosed? What tests are done?

In fact, diagnosing paralysis in young children can sometimes be a bit challenging . Because, as mentioned earlier, the symptoms are not always obvious. So some children may not get treatment right away. Sometimes doctors realize when they see a developmental delay in a child, and they think, 'Oh, this child may have had paralysis before.'

To make a diagnosis, the doctor will first ask you about your child's symptoms. Then they will examine the child. In addition, they may do the following tests:

• CT scan (Computed Tomography scan): This takes pictures of the head to see if there is bleeding in the brain or if a blood clot has damaged part of the brain. This is a quick test.
• CT angiogram: This checks the blood flow through the heart, blood vessels, and brain.
• MRI scan (Magnetic Resonance Imaging): This is the most sensitive test for diagnosing a stroke. An MRI allows doctors to see the brain's structure and blood vessels very clearly.
• MRA (Magnetic Resonance Angiogram): This also looks at how blood flows.

In addition to these main tests, other tests are done to find the cause of the paralysis and to look for other complications (especially seizures) that may occur:

• Echocardiogram (Echo): This examines the structure of the baby's heart.
• EEG (Electroencephalogram): This test is done to determine exactly whether the child is having a fit.
• Blood tests: Check for blood disorders such as sickle cell disease or other conditions that affect blood clotting.
• Genetic testing: This test is done if a genetic condition is suspected to be the cause of the paralysis.

How is infantile paralysis treated?

Paralysis is a life-threatening emergency. Therefore, if a child shows signs of paralysis, they should be taken to the nearest hospital emergency room without delay, or they should call 1990. The time to start treatment is very important.

Treatment varies depending on the type of paralysis:

• For a stroke caused by a blood clot (ischemic stroke): Doctors often give medication (thrombolytics) to dissolve the blood clot, or sometimes they remove the blood clot through a procedure called thrombectomy and restore blood flow to the brain.
• For a stroke caused by bleeding in the brain (hemorrhagic stroke): Surgery may be necessary to stop the bleeding.

Every hospital has a specific procedure, called a Stroke Protocol , that is followed for pediatric stroke. This is how the disease is diagnosed and treatment begins as soon as possible.

In addition to these main treatments, doctors may use other medications:

• Anticoagulant medications .
• If the child has a fit, they will be given antiseizure medications to control it.

How long does it take to recover? How is the rehabilitation?

Every child recovers differently and the time it takes is different. After a stroke, a child will likely need to go to a pediatric stroke rehabilitation program. Depending on the child's symptoms, they may receive treatment from a team of specialists. These include:

• A pediatric neurologist .
• A pediatric cardiologist .
• A doctor who specializes in diseases of the blood, bone marrow, and lymphatic system (Pediatric hematologist) .
• A pediatric neurosurgeon.
• Physical therapist – Exercise the affected side of the body.
• Speech-language pathologist (SLP) – helps with speaking and swallowing.
• Occupational therapist – Practice doing daily tasks on your own.

What are the chances of surviving polio?

Researchers in childhood stroke have found that the longer the diagnosis is delayed, the greater the impact on health outcomes. Many children who have had an ischemic stroke survive. However, they may be at risk for another stroke, especially if they have heart disease or blood clotting problems.

Can polio be prevented?

Cerebral palsy can occur for a variety of reasons. Some are congenital conditions. So there is no way we can prevent some congenital conditions. If your child has a medical condition, talk to your doctor about it and get advice on how to keep your child healthy.

If your child has conditions such as Arteriovenous Malformation (AVM) , Congenital heart disease , or Sickle Cell Disease , doctors will treat those conditions. These treatments can help reduce the risk of future strokes. Some children may also need regular surveillance tests to see if they are at increased risk of strokes.

Is there a risk during pregnancy?

Yes, sometimes a baby can have a stroke (perinatal strokes) due to blood clots that form at birth or shortly after birth. Certain conditions that the mother has during pregnancy can also increase the risk for the baby. Examples:

• Gestational diabetes.
• Preeclampsia is a high blood pressure condition.
• Premature rupture of membranes .

Therefore, it is very important to talk to your doctor about ways to minimize possible complications during pregnancy.

What can I do to reduce my child's risk of paralysis?

Talk to your doctor about your child's risk of stroke. Some children are given medication to prevent blood clots, which can help prevent stroke.

Additionally, if your child is recovering from a stroke, follow your doctor's instructions exactly. Give all medications as prescribed. The child:

• You need to exercise well and stay active.
• You need to eat nutritious foods (control the risk of high cholesterol and diabetes).
• You need to get enough sleep.

When should you take your child to a doctor? When should you go to the Emergency Department (ETU) ?

After a stroke, your child may need treatment from a team of specialists. Be sure to take your child to all appointments with the doctor. If you have any concerns about your child's health or development, especially if you notice any new symptoms, call your doctor right away.

If your child shows signs of a stroke, call 911 or take them to the nearest hospital immediately. A stroke is an emergency. Getting treatment quickly can go a long way toward improving your child's health.

The most important things we need to remember

Okay, so from what we've discussed, I hope you have a good understanding of Pediatric Stroke . Remember, this is a very rare occurrence. But, if it does happen, it's important to act quickly.

• Symptoms of paralysis in young children can be different from those in adults. Be especially aware of things like seizures, sudden changes in behavior, and weakness on one side of the body .
• If you notice these symptoms, see a doctor without delay, or call 1990.
• If your child has any risk factors, such as heart disease or blood-related diseases, always talk to your doctor about it and get the necessary treatment.
• Don't be afraid. Awareness is the greatest strength. The best thing you can do for your child is to be aware of these things.

` Pediatric Stroke, Paralysis, Stroke, Pediatrics, Brain Hemorrhage, Blood Clots, Newborns, Child Health