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| Vital research into childhood stroke |
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Stroke is often associated with older people, so it may come as a surprise to learn that stroke is one of the top 10 causes of death in children. It is particularly common in newborns, and in their first week of life, a term baby has a stroke risk three times that of a hypertensive, smoking, diabetic adult.
This is a sobering thought, and there are also ongoing challenges for young stroke survivors. So it may come as another surprise that there has been precious little research into childhood stroke.
Fortunately, the Murdoch Children's Research Institute (MCRI) has gone some way to remedying this, by looking at youngsters' motor skills function after a stroke.
The first study of its kind, the MCRI followed 64 children for 12 months after they were diagnosed with an arterial ischaemic stroke (one caused by a blood clot).
Researchers divided the children into three groups: Neonates (less than 30-days-old), pre-schoolers (30 days to five-years-old) and school children (five to 18-years-old). Then they analysed the children’s motor function progress at four points in time – acute (when they'd just had the stroke), one month, six months and 12 months.
What did they look for?
Researchers looked at how each child's motor skills had been affected by the stroke and studied their recovery. They also looked at how the motor impairments affected the children's day-to-day lives.
What did they find?
The MCRI study highlighted four key points:
1. Children and adults have different care needs
The study showed that children who suffer a stroke need individualised care over a much longer time frame than adult stroke-sufferers.
Because children change developmentally as they grow, children who’ve had strokes need to be monitored and assessed over the long-term. This differs from adults who have the ‘best rehab stroke potential’ in the first three to six months after the health event.
2. Childhood stroke motor outcomes are affected by age
Researchers found that motor outcomes differed, depending on how old the child was when they had the stroke. Lead researcher, Anna Cooper said, 'In babies, impairments tended to emerge over the first year, whereas in older children we saw an improvement.'
In terms of age, the study suggests that pre-school aged children may have the best motor outcomes and recovery potential.
3. Childhood stroke can have long-term implications
Whether they had the stroke as a newborn or as an older kid, the study found that childhood stroke can have major implications for a youngster's development and can lead to life-long challenges.
Ms Cooper said, 'The problems are quite similar to those seen in the elderly – motor, speech and cognitive impairments which limit children's participation in normal daily activities such as school, sport and socialising – impacting them across their lifetime, even into adulthood.'
4. Social and behavioural effects may emerge later
Researchers discovered that social and behavioural problems often aren't apparent in the early stages of childhood stroke recovery, so might not be visible to health carers then.
Co-author MCRI Research Coordinator, Mardee Greenham said, 'Our study found that social and behavioural problems begin to emerge at 6 and 12 months after stroke, highlighting the importance of monitoring children long-term. Social and behavioural difficulties are linked to long-term quality of life, mental health and academic success.'
What didn't they find?
Researchers did not discover significant links between motor outcomes and which part or side of the brain was affected by the stroke.
Also, the gender of the child made no difference to their findings.
What next?
MCRI researchers are creating some clinical guidelines to establish a uniform practice for diagnosing and caring for children affected by stroke.
The next stage of the study is when researchers follow up with the children at five years.
What are the signs of childhood stroke?
Because childhood stroke can have such far-reaching consequences, it’s important to be able to recognise the signs of a stroke.
According to the Stroke Foundation, strokes in babies often show as seizures, but they can be missed until parents notice, later on, that their baby is having trouble moving a part of their body.
For toddlers and older children, these sudden signs may point towards a stroke:
- Weakness in an arm or leg, especially on one side, which may make walking, standing or using the arm difficult. Older kids may feel numbness in the limb.
- Difficulty talking, understanding, reading, writing or concentrating.
- Trouble seeing in one or both eyes.
- Dizziness, loss of balance or poor coordination.
- Difficulty swallowing, including drooling.
- Severe or unusual headaches, nausea or vomiting.
- Occasionally strokes can cause kids to collapse, change behaviour or have a seizure.
Seek immediate medical attention if a child is exhibiting any of these signs.
To learn more about childhood stroke, see the Stroke Foundation's Childhood Stroke Booklet.
References
Murdoch Children's Research Institute
Stroke Foundation
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