Shedding pediatric stroke misconceptions

·2 min read

May 18—Children don't get strokes.

Even with the amount of awareness on pediatric strokes that's out there in the public eye, Dr. Nihal Bakeer, a pediatric hematologist with the Indiana Hemophilia and Thrombosis Center, said it's one of the most common misconceptions related to the topic.

And she wants to quickly change that narrative.

"I think it's because of the complexity of strokes and their presentation (signs and symptoms) in children," she said, when asked why some people have this misconception. "In adults, when they get strokes, you know the obvious signs. All of a sudden, you have an adult who's not walking and talking, has a facial droop and trouble moving on one side of the body.

"Pediatric strokes are different," Bakeer continued. "Sometimes you get a facial droop, and it ends up being Bell's palsy. A lot of time you have weakness on one side, and it ends up being something called Todd's paralysis that might come after a seizure. ... So I think one of the reasons this myth exists is the complexity of the presentation."

Bakeer added that pediatric strokes are still not very common, however, citing data from the American Heart Association to support that claim.

"As of 2019, the incident of ischemic strokes (caused by blood clots) is 3.3 per 100,000 children," she said. "Usually we say 2 to 5. And then hemorrhagic strokes (brain bleeds) are 1.8 per 100,000. ... And a good number of them, you never find a reason, though they can be related to falls or injuries, a bacterial infection, a congenital heart disease or other increased risk factors (birth control, morbid obesity, smoking and sedentary lifestyle)."

And as is the case with adults, when a child has suffered or is currently suffering from a stroke, time is critical, Bakeer noted, adding that the most optimal window for intervention is sometime within the first 24 hours after a pediatric stroke has occurred.

So it's important to know the warning signs, Bakeer pointed out, aided through the use of a mnemonic device.

"It's called BE FAST," she said, which stands for balance, eyes, face, arms, speech and time. "If a child is having an immediate issue, it's time to call 911 or your medical provider immediately."

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