STROKE is also referred to as Brain attack.

• It is a sudden incident where there is a disruption(stoppage) of blood supply to the brain.

• Blood to the brain, like any other part of the body, is delivered by vessels (arteries).

• When they get clogged or if the vessels rupture, they can cause a stroke.

• Without a constant blood supply, the brain cells can die because of lack of oxygen and nutrients. Brain cells, unlike liver or lungs, cannot regenerate. So damage may be serious most times depending on the extent of brain damage and area involved.

• If the part of brain controlling speech is affected, then there may be problems with speech, if the hearing part is damaged, then hearing of child is affected.

• It can occur at any stage of life depending on the cause. Even babies in the womb can be affected if blood supply to the brain is problematic. It can also be apparent in first months of life or even later.

 

CAUSE

• Determining the cause can be difficult at times.

• Children may need complete evaluation with various blood tests, imaging and family history details to rule out possible causes.

 

Some risk factors for stroke are

Birth asphyxia-

• When the child has difficulty at birth to establish breathing they can undergo brain insults due to less oxygen reaching the brain.

 

Problems in blood supply-

• Blood reaches the brain by arteries.

• When any disease (infection or genetic abnormality) affect the functioning of arteries, they can increase the risk of stroke.

• The damage may be caused by inflammation of arteries, sudden blockage of an artery or even sudden rupture.

• All these factors decrease blood supply to the brain

 

Brain tumours-

• Can cause uncontrolled bleeding occasionally as the cancer cells can invade the blood vessel.
• A migraine and certain medications can also contribute to the risk

 

Heart causes-

• The heart pumps blood to the brain. so any clog or clot circulating in the heart can be pumped to smaller arteries in the brain and cause obstruction of blood supply

 

Clotting problems-

• If the child has a tendency to bleed when there is blood loss and similarly over enthusiast clotting mechanism can cause clots in the body.

• So there is constant regulation of these factors to maintain blood in the acceptable fluid state.

• A defect in any of this mechanism can cause a stroke by either bleeding or forming clots

Trauma to head or certain blood disorders, dehydration  also add to the risk

 

SYMPTOMS

• Any sudden deterioration of neurologic system like paralysis, eye movement defect, imbalance, sudden unexplained weakness, or stiffness in muscles, loss of taste, numbness in any part of the body, abnormal sensation should be completely evaluated by medical professional and stroke should be suspected.

• A headache, sudden worsening of vision may present.

• In babies, they can present with fits or decreased usage of particular part of the body( like hands)

• In children, the signs of stroke may be subtle and children may not complain of any. hence a high degree of suspicion is important

 

INVESTIGATIONS

• The main aim of the investigation is to find what could be the possible cause and severity of the bleed. This is because the treatment varies for each condition and it is very important to know it beforehand

• Blood tests to look for bleeding, clotting problems, or infections

• CT scan- helps identify the larger affected area and bleed. It is a quick process where series of X Rays of the brain are taken. Occasionally a chemical is injected to outline the vessel characters.

• MRI- magnetic rays are used to visualise smaller bleeds in the brain

• Lumbar Puncture- the fluid is drained from the spine ( back) and looked for infection, inflammation, or bleed

• A scan of heart(ECHO) and electric reading of heart(ECG)

 

TREATMENT

• This is an emergency. Always see your doctor

• The brain needs to be protected by maintaining normal oxygen levels, blood pressure, sugar levels.

• If a clot is strongly suspected, measures to dissolve it is started. (Heparin ) the treatment may go on for months with repeat imaging of the brain to see the size of the clot.

• If bleeding is the cause of stroke, then surgical measures are undertaken immediately to control bleed.

• Medications may be started to prevent more clot formations. Regular blood to monitor the clotting ability is done.

 

REHABILITATION

• Helps the child recover the physical functions

• Children are likely to regain the most function in the first six months. They may continue to improve for two years or more. The degree of involvement, the cause, severity of brain damage and response to treatment.

• Talk to your doctor for more details