New Guidelines on Infant Stroke Released

Experts note symptoms and treatment of these youngest patients differ from adults

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THURSDAY, July 17, 2008 (HealthDay News) -- In its first guidance on stroke in children, the American Heart Association/American Stroke Association stated that stroke in this younger population is not as rare as once believed and, importantly, that the symptoms tend to be different than those in adults.

Risk factors and treatment are also different in children than in adults.

"Children and adolescents with stroke have remarkable differences in presentation compared with adults," Dr. E. Steve Roach, chairman of the statement writing group and a professor of pediatric neurology at the Ohio State University College of Medicine, said in an American Heart Association news release. "In newborns, the first symptoms of stroke are often seizures that involve only one arm or one leg. That symptom is so common that stroke is thought to account for about 10 percent of seizures in full-term newborns. Seizure is a much less common stroke symptom in adults."

In both children and adults, however, diagnosing and treating as quickly as possible are critical to recovery.

According to the Management of Stroke in Children statement, published in the current issue of Stroke, the risk of having a stroke before the age of 18 is 10.7 per 100,000 children per year. The risk is greatest during the first year of life.

The most common risk factors for stroke in children include sickle cell anemia and congenital or acquired heart disease. Other risks include head and neck infections, systemic problems such as inflammatory bowel disease and autoimmune disorders; head traumas, and dehydration.

Risk factors in the mother that contribute to a stroke in the infant include a history of infertility, premature rupture of the membranes, and preeclampsia.

Using the clot-busting drug tissue plasminogen activator (tPA), while standard in adults, is generally not recommended for children at this time. Underlying risk factors should be addressed.

The statement also added that a good number of cases of cerebral palsy may be caused by strokes immediately before or after birth.

More information

Visit the American Stroke Association for more on pediatric stroke.

SOURCE: American Heart Association, news release, July 17, 2008

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