Contributor: pediatric neurologist and stroke specialist Neil Friedman, MBChB
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You may not think to look for signs of stroke in a child, and thankfully, strokes are not common in young people.
A stroke, which blocks blood flow or causes bleeding in the brain, can happen at any age. It’s a myth that only older adults have strokes. Even newborns, infants and very young children can suffer a stroke.
That’s why it’s so important to recognize signs of stroke and know the risk factors for all ages.
The risk of stroke in children is greatest in the first year of life and during the period around birth. Stroke remains among the top 10 causes of death in children, according to the National Stroke Association.
7 signs of stroke in infants and children
You know your child best. And with stroke, time is of the essence. You can help by telling doctors what unusual symptoms you are noticing.
Watch out for these signs of stroke in children:
- Severe and sudden headache with vomiting and drowsiness
- Vision loss or double vision
- Severe, intractable dizziness
- Loss of balance or coordination
- Seizures on one side of the body
- Numbness or weakness on one side of the body
- Difficulty speaking or understanding others
In very young children, it is easy to misunderstand or miss the signs of a stroke. As stroke isn’t common in babies, kids or adolescents, doctors may attribute symptoms to a more common ailment.
If your child seems abnormally drowsy, has been vomiting excessively or has a sudden onset severe and intractable headache, the pediatrician may suspect a stomach bug.
If your child has new onset slurred speech, focal weakness or double vision — these, too, may be signs of stroke. In a very young child, however, speech is often unclear, and a child may be unable to report double vision. Similarly, weakness of an arm or leg may be difficult to identify.
This all creates challenges in interpreting symptoms, but never hesitate to reach out to your doctor if you suspect something is amiss with your child.
How to remember signs of stroke
One way to remember the signs is to know the acronym — BE FAST:
Balance – Sudden loss of coordination, balance, trouble with walking or dizziness
Eyes – Sudden change or loss in vision (double vision, blurry vision or the feeling of a shade coming down over the eye)
Face – Sudden weakness or asymmetry of the face
Arms – Sudden weakness or numbness of the arm and/or leg
Speech – Sudden difficulty producing speech or language (trouble finding words or understanding spoken and/or written commands)
Time – Time to call 911 and note the time symptoms started.
RELATED: 5 Things You Don’t Know About Childhood Stroke
What causes stroke in different age groups?
While high blood pressure, an irregular heartbeat and a hardening of the arteries are common causes of adult strokes, they are rare in children.
The most common stroke risk factors for children at the age of 1 month to 18 years include:
- Congenital or acquired heart disease
- Genetic disorders affecting brain blood vessels
- Sickle cell disease
- Autoimmune disorders
- Head or neck trauma
- Infections affecting the brain, such as meningitis
In about a quarter (20-25 percent) of childhood strokes, doctors don’t find any previous risk factors.
Treatment needs to start quickly and depends on cause
The most important thing to remember is to call 911 and get help quickly if you think your child has had a stroke.
Often, paramedics will know which nearby hospitals have specific expertise in treating pediatric stroke. Fast treatment helps limit brain damage. It can also head off permanent complications, such as weakness, vision problems or seizures.
Experts say treatment approach depends on what caused the stroke in the first place.
Doctors treat adults with medications that dissolve blockages. A specialist also may use a catheter to remove the blockage. The problem is that these treatments aren’t FDA-approved for use in children but in the correct setting, and done in conjunction with a pediatric stroke expert, they may be appropriate to consider.
RELATED: Pediatric Stroke Factsheet (PDF)
As a child recovers, the doctor focuses on identifying and treating the condition that caused the stroke.
For instance, if a child has sickle cell disease, blood transfusions can reduce the risk of repeat strokes. If a congenital heart defect is the problem, a child may require surgery. Sometimes re-establishing blood flow to the brain may be appropriate.
Maximizing your child’s developmental potential and recovery following stroke requires a team approach including physical, occupational and speech therapy as appropriate. Braces and orthotics may also be necessary at times.
The bottom line: Act FAST and call 911 if you suspect your child or anyone else is having a stroke.
RELATED: Stroke Treatment Guide