Every year, 300 to 500 children and adolescents between the age of 29 and 18 suffer a stroke in Germany. While in adults, in many cases, lifestyle is responsible for the circulatory disorder in the brain, the possible causes in younger children are complex. They require a thorough, multidisciplinary examination.
Childhood strokes are rare and strike young patients suddenly and unexpectedly. This makes it all the more important to interpret the signals correctly and react quickly. The earlier a stroke, as it is commonly known, can be treated, the better the chances of recovery without serious consequences. At the Vivantes Children's Clinics in Hospitals Friedrichshain and Neukölln, specialists from numerous departments work hand in hand when it comes to getting to the bottom of the individual causes of strokes as quickly as possible and providing targeted therapy for the affected children. Prof. Dr. Hermann Girschick, Director of the Vivantes Clinic for Pediatrics and Adolescent Medicine in Friedrichshain, explains how a stroke can occur at a young age and what treatment options are available to doctors and therapists.
What are the causes of strokes in childhood and adolescence?
The causes in young patients are very complex. Congenital malformations in blood vessels, for example aneurysms or hemangiomas, can cause free bleeding in the brain, which leads to disturbances in the supply of nerves. A brain tumor can also pinch off nerves and cause a stroke. In addition, there are autoimmune diseases in which the immune system attacks brain vessels. This leads to vascular inflammation, which can result in a circulatory disorder. In very rare cases, congenital coagulation disorders lead to vascular occlusion and stroke.
Does this also apply to newborns?
In newborns, we speak of a neonatal stroke. Here, a complicated birth, such as a forceps delivery, is often the cause. Prematurity can also favor the development of a stroke, since the vessels in premature babies are very fragile and sensitive.
How can I tell that my child is having a stroke?
Exactly how a stroke manifests itself depends on the severity, cause and area of the brain affected. Strokes caused by bleeding and brain tumors result in severe headaches that resemble a severe migraine. Sufferers experience this as a painful sting or blow to the head. If the circulatory disorder damages motor-relevant areas in the brain, paralysis symptoms set in. If the speech center or the visual cortex are affected, blurred, restricted speech or severely impaired vision may occur. Such symptoms of failure and sudden, massive headaches are alarm signs to which parents should react immediately.
What are the first rescue measures I can take if I suspect something is wrong?
The motto "time is brain" applies here. In any case, you should call an emergency physician, express the suspicion of a stroke and ensure that the child is taken to a large children's hospital with neuroradiological diagnostics and a specialization in the direction of pediatric neurology and pediatric immunology.
What happens in the clinic?
The first step is a comprehensive differential diagnosis. Specialists in neurology, blood clotting, autoimmune diseases and tumors come together and contribute all their knowledge to find the cause of the stroke as quickly as possible. Then each young patient receives treatment specifically tailored to his or her clinical picture.
What treatment methods are available?
If doctors detect vascular inflammation due to an autoimmune disease, it may be necessary to suppress the immune system in a controlled manner over a longer period of time. In the case of malpositions in vessels and brain tumors, surgery or the use of beta blockers are possible measures. If a vascular occlusion is present, clot-dissolving therapy is conceivable. The most common form of treatment, however, is symptomatic therapy: experts try to compensate for and alleviate the consequences that have occurred as a result of a stroke.
How does rehabilitation proceed and what are the chances of recovery?
Rehabilitation in childhood is carried out according to the respective underlying disease in cooperation with physiotherapists, speech therapists, occupational therapists, immune specialists and neurologists. They accompany the young patients, sometimes over several years. Children are very capable of learning and therefore have a good chance of recovery. Depending on the severity of the stroke, the children may be left with limitations, but experience shows that they are able to cope well with these. Thus, the prognosis is positive in many cases.