What are the first signs?

If brain vascular accidents (stroke) concern above all adults (this is the third cause of mortality after cancers and myocardial infarction in those over 18), These brain attacks also affect children, even if it’s rarer. Approximately 1,000 children and infants in their victims each year. So few children die (approximately 10 %), this pathology is the first cause of acquired disability of the child. A Strokealso called “brain attack”, takes place when the normal blood circulation is interrupted and that a (more or less important) region of the brain ceases to receive its usual blood intake. It occurs most often (80 %) by obstruction (ischemic stroke) or by the rupture of a blood vessel (hemorrhagic stroke). Which causes the Death of nerve cells and the loss of brain functions. Avant-current symptoms, treatments, consequences and consequences.

At what age is the stroke in children?

First of all, you should know that the pediatric stroke can take place:

► During the perinatal stadium: we then speak of fetal stroke, before birth (in practice, the fetal stroke occurs during the 3rd trimester of pregnancy), and neonatal stroke, from birth to 28th day after birth. “”Among the 1,000 children victims of stroke each year, the half are newborns less than 28 days old“, Specifies Dr. Céline Bellesme, neuro-pediatric at the Kremlin-Bicêtre CHU;

► During infant stage which begins from the 29th day of life until the age of 3 years;

► During Childhood stage which concerns children over 3 years old until adolescents aged 18 years.

What are the causes of stroke in children?

“”With the newborn, half of the causes of the stroke remain unknown. It is believed that it is due to a problem of feto-pavement traffic (tailfish formation or flow problem which no longer allows the umbilical cord and the placenta to feed the fetus), but we are not sure of it“explains the neuro-pediatrician. In some cases, the stroke may be the consequence of a congenital heart disease or infection, problems related to the placenta, a blood coagulation disorder or intense dehydration. In baby over 28 days and children, the brain attack may be due to a Congenital anomaly, heart problems, blood vessels disorders, an infection, to a blood disease as leukemia or sickle cell anemiaa head trauma … “In any case, finding the cause makes it possible to guide the care of the child“, Specifies the specialist.

What are the first signs of stroke in children?

After 28 days of life and the more the child growsthe more the warning signs of a stroke are almost similar to those of the adult:

• weakness or paralysis on one side of the body which appears suddenly, most often upon waking;
• having suddenly having speech difficulties (speech disturbances …);
• having Difficulties to remain awake and vigilant Outside nap and sleep hours;
• the appearance of convulsive disorders or acute headache (very intense, unusual and brutal headache, brutal vision disorder)

How to recognize stroke in children?

According to an Odoxa survey for the foundation for research on stroke of October 2018, nearly 8 out of 10 French people admit that they do not recognize the symptoms of the stroke in an infant or a child. And for good reason, the symptoms of stroke in a newborn or a very young child (under 3 years old) can be very different from those in adults and are often difficult to spot.

Symptoms sometimes different from those in adults.

“”The only signs of a perinatal stroke are the appearance of convulsive disorders (eye revulsion, brutal passionate access, repetitive movements (face, suction, eyes … like a rapid succession of grimaces, blinking of eyelids …), fixity of the gaze, respiratory apnea …). The smaller the baby, the more brain assault can be convinced“Explains the neuro-pediatrician.”The baby may not convulse and in this case, the stroke of the newborn Completely unnoticed. It is only after a few months when its motor skills will be refined (4-6 months, but it can be later) that doctors can notice a weakness on one side of the body, systematic use of one hand, toes curled up on one side or one of the two fists too often closed. And it’s rather common. If half of the newborns having made a stroke convulsed at birth, the other half does not have visible signs“”adds the specialist.

What to do in case of stroke symptoms in children?

L’very sudden appearance From certain symptoms (excluding trauma type fall or injury) such as inappropriate words, the inability to speak, vision problems (troubled vision, blindness), numbness, inability to move one side of the body, very intense headaches, convulsive disorders or a modification of liveliness can be considered as signs of alert. These symptoms increase in a few minutes. They can sometimes occur during sleep and can be very marked when the child wakes up. In doubt, do not wait until these symptoms persist and react immediately. Call 15 (SAMU). “”The SAMU regulatory doctor will organize the transfer in a neurovascular unit, if the suspicion of stroke is confirmed“, Specifies the foundation of research on stroke. And add”that the symptoms should not be minimized by finding them a reassuring explanation and that it should not be reassured if the signs fade. Better to call it wrong than too late“”. Knowing these symptoms helps prevent the risk of brain damage and maximizes the chances of intervening quickly.

What treatments against the child’s stroke?

There is no Standard stroke treatment in children, It all depends on the causethe exact location of the stroke and the consequences it left. Most often, the child will have to recover his motor and intellectual faculties via a Psychomotor rehabilitation (at the hospital, then with liberal specialists such as physiotherapists, speech therapists or occupational therapists …), more or less or less or less long depending on the type of stroke and the diagnosis which was made. THE drug treatments (thrombolytic drug) remain very rare in children To treat the consequences of a stroke. “”Because on the one hand, we rarely have the authorizations of the administration of this medication in those under 18 and on the other hand, this drug must be administered within 4:30 am which follow the start of the stroke. Most children arrive in the emergency room after this period. You should know that the average time of consultation of a child for a suspicion of stroke is 24 to 26 hours after the start of the first symptom“Concludes Dr. Bellesme.

Thank you to Dr Céline Bellesme, neuro-pediatric at the Kremlin-Bicêtre CHU.