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Unfortunately, the disease affects everyone, so it is possible for children and very young people to suffer from a stroke. Fortunately, it is quite rare at a young age, in around 3 people / 100000 / year. Among these patients, ischemic stroke accounts for 30% to 50%. As in adults, also in children, the effects of acute CNS ischemia are the cause of various long-term and often permanent disorders that affect future life. These are movement disorders, paresis, impaired speech expression, cognitive deficits, delayed development of higher nervous functions. The consequence of these changes is worse functioning of the child not only in the motor and cognitive sphere, but also in the social sphere.
The risk factors for stroke in patients of developmental age are much less known than in adults. Despite the great progress in knowledge and research, the cause of stroke among young patients remains unknown in 20% -30%. However, it should be sought at all costs, as some diseases can cause recurrent strokes. Finding out the cause after the first stroke and implementing appropriate therapeutic and diagnostic procedures may save the child from another stroke.
The etiology of strokes in children is often complex, involving the coexistence of genetic, developmental, metabolic, immunological and environmental factors. Contrary to the causes of stroke in adults, lifestyle (stress, drugs, low physical activity, obesity) is of less importance.
The most common causes of stroke in children are:
- – congenital heart defects,
- – acquired heart defects (endocarditis and myocarditis, rheumatic disease, cardiomyopathy, arrhythmias),
- – systemic vascular diseases,
- – inflammatory diseases of various etiology and localization,
- – blood coagulation disorders,
- – disturbances in the structure and function of blood vessel walls,
- – anomalies of the cerebral vessels (aneurysms, hemangiomas),
- – head injuries as well as injuries to distant parts of the body.
Due to the early onset of sexual activity and the use of contraceptives by adolescents, the increased risk of ischemic stroke in this group of patients should be mentioned. Some activating substances and drugs used by adolescents cause an increase in blood pressure and / or vasoconstriction, thus increasing the risk of stroke.
Vascular brain damage is more common in newborns than in older children, and among newborns, premature babies are a group at greater risk of developing these disorders (mainly hemorrhagic).
symptoms
The most common are disturbances in consciousness, contact with the environment, speech disorders, sensory disturbances, motor symptoms in the form of muscle weakness or paresis.
The most common symptom of acute vascular disorders in newborns and small children is an epileptic seizure. Other symptoms include irritability or drowsiness, breathing problems, and often bulging fontanelles. In a young child, the paresis may not be visible from the beginning of the stroke.
It is much easier to recognize the symptoms of a stroke in an older child (paresis, other focal symptoms), but they are often overlooked in the first phase, as many parents do not realize that a child may develop such a serious condition as a stroke.
Procedure
At any age, a stroke is a medical emergency. If not properly managed, it can quickly lead to respiratory, circulatory and central nervous system failure. The patient’s life and condition after the acute symptoms of brain damage have subsided depend on the speed of diagnostic and therapeutic measures.
For this reason, it is important that the patient is admitted to hospital as soon as possible after the onset of disturbing symptoms, suggesting a stroke.
Rehabilitation
In fact, from the very first day of the disease, i.e. very early, the patient should have implemented comprehensive procedures aimed at improving the functions lost due to the disease.
A rehabilitator and speech therapist should work with the patient, and then an occupational therapist, psychologist, and educator.
The child’s family should be involved in the rehabilitation process, as it is responsible for creating good conditions for rehabilitation.
It should be remembered that we treat a person and not only a disease, and that the aim of therapy is to restore the patient’s physical, mental and social activity and as much independence as possible.
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