Stroke in children (Paediatric stroke) ~ Causes ~

(If you missed last week's post, you can find it here.)

Stroke can happen at any point in a person’s lifetime, from infancy and childhood to adulthood. A stroke is caused by the interruption of normal flow of blood to the brain, either by a blockage or a rupture in the blood vessels. When a part of the brain doesn't receive its regular flow of blood that carries vital nutrients and oxygen, brain cells die, causing a loss of brain function.

The age of the child at the time of stroke makes a difference in how doctors identify and treat the problem. Stroke can occur in these three different age groups: 

• The prenatal phase, or in the womb
• The first 28 days of life, or newborn phase
• The infant years up to 18 years of age 

Stroke is relatively more common in the first two age groups, occurring in up to one in every 4,000 live births. In the third age group, stroke is more rare, only affecting about five out of every 100,000 children each year in Canada.

The location in the brain the stroke takes place will determine the extent of the damage and the after-effects, if any.

Children may experience two types of stroke: hemorrhagic stroke (rupturing of blood vessels), or ischemic stroke (blockage caused by a blood clot).  

 ~The causes of stroke in children ~

The reasons why stroke occurs in children are varied and include malformations of the blood vessels and rare diseases. Here are the most common causes:

Hemorrhagic stroke occurs when a blood vessel ruptures in the brain. In children, it may be due to a weakened or malformed artery. If an artery wall is weak, blood can collect in the wall causing it to balloon (aneurysm). If the pressure builds, the aneurysm can rupture. When this happens, two problems arise. One is that blood flows into areas of the brain where it doesn’t belong, and second, blood fails to reach its destination, depriving that part of the brain of oxygen and nutrients.

The causes of hemorrhagic stroke in children include: 

• an artery malformation or disorder
• a brain tumour
• drug or alcohol abuse by the mother (rare)

Ischemic stroke is usually caused by a blood clot in the brain. The leading risk factors for ischemic stroke in children include:  

• Heart disease When children are born with a heart defect (congenital heart disease), their risk of having a stroke is increased. Heart disease, such as rheumatic heart disease, can also be acquired later in childhood. Stroke is not usually the first sign of heart disease. Often heart disease has been diagnosed before the child has a stroke. 
• Blood-clotting disorders Blood-clotting disorders, also known as prothrombotic disorders, cause the blood to thicken and clot faster. These disorders can be present at birth or acquired later on. A child can be born with a genetic mutation that makes the blood clot faster. Stroke is often the first sign of a blood-clotting disorder. Some illnesses, such as meningitis, sepsis, diarrhea, dehydration or an iron deficiency, can also lead to a blood clotting disorder.  
• Irregular arteries A child can have a stroke because the arteries in the brain are irregular or narrowed. This is called arteriopathy. Often, children are born with this problem, but it often goes undetected. In these cases, stroke is the first sign of an irregular artery problem. Children with irregular arteries need to be monitored very closely by their stroke clinic team because 25% of them will experience another stroke. 
• Viruses Stroke can also be indirectly caused by a virus. One of the culprits is the chicken pox virus. Once a child is infected, the virus can lie dormant in the body. When the virus is triggered, it can attack an artery in the brain.  
• Other risk factors Children are also at higher risk of having a stroke if they have any of the following risk factors: 
  • heart or brain surgery
  • moyamoya disease
  • sickle cell disease
  • autoimmune disease that attacks arteries in the brain
  • trauma to the brain or neck
  • leukemia
  • migraine headaches with aura
  • metabolic illness

Up to 20% of paediatric stroke cases have no known cause. This is an area of active medical research.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - Causes √ 
• Stroke in children (Paediatric stroke) - Diagnosis, Treatment and Rehabilitation
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

STROKE - Hemorrhagic stroke

(If you missed, Transient Ischemic Attack (TIA or mini-stroke), part 2 - you can find it here)

Hemorrhagic stroke -

About 20 per cent of strokes are hemorrhagic, which means they are caused by uncontrolled bleeding in the brain. This bleeding interrupts normal blood flow in the brain and by flooding the brain, kills brain cells.

There are two main types of hemorrhagic stroke:

Subarachnoid hemorrhage is uncontrolled bleeding on the surface of the brain, in the area between the brain and the skull.

Intracerebral hemorrhage occurs when an artery deep within the brain ruptures.

Both types of hemorrhage can be caused by structural problems with the blood vessels in the brain. These include:

Aneurysm: A weakened area in the blood vessel wall of the blood vessel that fills with blood and bulges. High blood pressure or trauma can cause the bulge to rupture, resulting in uncontrolled bleeding into the brain.

AVM (Arteriovenous Malformation): A malformation of the brains blood vessels usually present at birth, that causes the artery walls to be weak and increases the risk of hemorrhagic stroke.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic Stroke √
• Stroke in children (Paediatric stroke) - next Wednesday
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

STROKE - Transient Ischemic Attack (TIA or mini-stroke), part 2

(If you missed, Transient Ischemic Attack (TIA or mini-stroke), part 1 - you can find it  here.)

TIA is a medical emergency.  Seek immediate medical treatment if you think you or someone else is having a TIA.

 Remember -  Take  Immediate  Action

What happens during a TIA?

You may feel any or all of the symptoms of stroke except they go away within a few minutes or hours. Learn more about the stroke warning signs.

Why is TIA an emergency?

A TIA is a very serious warning sign that says something is wrong with blood flow to your brain.

Calling 9-1-1 or your local emergency number ensures you will get help quickly. Doctors may be able to give you a clot-busting drug that restore blood flow to your brain. However, because the drug is only effective within the first three hours of the onset of symptoms, you must get to the hospital as soon as possible. Do not wait for your symptoms to disappear - call 9-1-1 as quickly as possible. Even if your symptoms do go away, it is important for you to find out what is causing these symptoms. 

A TIA is a serious warning sign that you are at higher risk for having a stroke.

If you have had a TIA, you are at a higher risk for having a stroke. The greatest risk is immediately after the TIA and llasts for up to one year later. The good news about TIA is that it provides a warning about your higher risk and gives you a chance to take action to reduce your risk.

What causes a TIA?

The most common cause of a TIA is a blood clot or plaque that prevents blood from flowing to your brain. Here’s how it happens:

TIA caused by plaque:	TIA caused by a blood clot:
Plaque refers to a build-up of cholesterol, fatty deposits and other substances. It gathers inside the wall of an artery and narrows the size of the blood vessel (also called atherosclerosis). This may reduce blood flow to the brain. Plaque can also break off and block arteries to the brain.	A blood clot may form in other parts of the body and travel to the brain. Many blood clots travel from the heart to the artery that feeds the brain. If you have atrial fibrillation (a fast, irregular heart rate),problems with your heart valves, a patent foramen ovale (a defect in the wall between the two upper chambers of the heart), or a weak heart muscle, you may be at higher risk for a TIA.

You may have other health problems that can cause a TIA. Talk to your healthcare provider about your health and whether you are at higher risk for TIA.

How do doctors know that someone has had a TIA?

It is sometimes difficult for doctors to know if you have had a TIA because the symptoms have usually gone away by the time the doctor sees you. The key to treating a TIA is knowing that a TIA has happened. The doctor may want to perform tests to find out the cause of the TIA. Once the cause is known, you and your healthcare team can work on a plan to prevent future TIAs or strokes. Read more about diagnostic tests.

How can I prevent another TIA? How to manage the main risk factors

The goal of treatment is to prevent you from having another TIA or a stroke. The way to reach this goal is to reduce your risk factors. While some risk factors are beyond your control, you can manage other risk factors by leading a healthy lifestyle, taking prescribed medications or having surgery.

Risk factors you cannot control 

Risk factors you can do something about

Treatments for TIA

Medications

Doctors may prescribe two main types of medication to treat TIAs - antiplatelets or anticoagulants (blood thinners). They prevent or destroy blood clots and can lower the risk of stroke in people who have had TIAs or previous strokes.

• Your doctor may also prescribe medication to control your blood pressure and improve your cholesterol. Read more about medications.

When you have been prescribed medication, you must:

• Take the medication as directed.
• Report any side effects to your healthcare team right away.
• Only stop taking the medication after you have talked to your healthcare team.
• Bring your medication with you in the original bottle each time you visit the clinic or doctor’s office.

If you have any questions about your medication, talk to your healthcare team.

Surgery

• Sometimes surgery is the best way to prevent a stroke. Your doctor will tell you if this is the right treatment for you. Read more about surgery and other procedures. 

Over several Wednesdays I will offer information on the following - 

• Anatomy of the Brain, √  Anatomy of the Brain, part 2 √
• Ischemic Stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √  Transient Ischemic Attack (TIA or mini-stroke) - part 2 √
• Hemorragic stroke - next Wednesday
• Stroke in children (Paediatric stroke)
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

STROKE - Transient Ischemic Attack (TIA or mini-stroke), part 1

TIA is a medical emergency.  Seek immediate medical treatment if you think you or someone else is having a TIA.

 Remember -  Take  Immediate  Action

What is a TIA?

The medical term is Transient Ischemic Attack (TIA). It is also known as a mini-stroke. It happens when a clot stops blood from flowing to the brain for a short time. The symptoms of TIA are almost the same as the symptoms of a stroke, however symptoms go away within a few minutes or hours. Having a TIA is an important warning sign. It tells you that you have a higher risk of having a stroke.

A TIA warns you of a stroke. It also gives you a chance to prevent a stroke.

For more information, please watch the following videos.

How to recognize, prevent and treat a TIA or mini-stroke - part one

How to recognize, prevent and treat a TIA or mini-stroke - part two

Over several Wednesdays I will offer information on the following - 

• Anatomy of the brain √
• Ischemic stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - part 1 √ ...next  Wednesday, part 2
• Hemorragic stroke
• Stroke in children (Paediatric stroke)
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica

Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.

STROKE - Ischemic Stroke

Ischemic stroke -

About 80% of strokes are ischemic, which means they are caused by the interruption of blood flow to the brain due to a blood clot. The buildup of plaque (fatty materials, calcium and scar tissue) is involved in most ischemic strokes narrowing the arteries that supply blood to the brain, interfering with, or blocking the flow of blood. This narrowing is called atherosclerosis. An ischemic stroke is either "thrombotic" or "embolic."

Thrombotic strokes are caused by a blood clot that forms in an artery directly leading to the brain. Embolic strokes occur when a clot develops somewhere else in the body and travels through the blood stream to the brain.

A TIA, or Transient Ischemic Attack which is also known as a "mini-stroke" is caused by a temporary interruption of blood flow to the brain. The symptoms (warning signs) are similar to an ischemic stroke except they go away within a few minutes or hours. Many people can have a TIA without even knowing it. A TIA is an important warning sign that puts you at increased risk of a full-blown stroke.

Over several Wednesdays I will offer information on the following - 

• Anatomy of the brain √
• Ischemic stroke √ 
• Transient Ischemic Attack (TIA or mini-stroke) - next Wednesday
• Hemorragic stroke
• Stroke in children (Paediatric stroke)
• Effects of a stroke

 All information contained in this post was obtained, with permission, from the Heart and Stroke Foundation  website. Please visit their site for more information.

Monica
Disclaimer

The material provided on this site is designed for information and educational purposes only. The materials are not intended to be a self diagnostic and/or self treatment tool. I encourage you to use this information as a tool for discussing your condition with your health practitioner.