Get the Facts about Pediatric Stroke 

Updated 2017 Fact Sheets for Childhood Stroke and Infant Stroke, in partnership with the American Heart/American Stroke Association! Childhood Stroke Facts, Childhood Stroke Facts/Spanish, Infant Stroke Facts, Infant Stroke Facts/Spanish

Downloadable fact sheet "Strokes Can Happen at Any Age" highlighting the risk factors, signs and symptoms of perinatal and childhood stroke. The fact sheet is also available in Spanish and Portuguese.
Fast Facts
  • Contrary to what most people believe, strokes can, will and do happen in children, infants and unborn babies.
  • There are two age categories for pediatric stroke:
    • Perinatal, which refers to the last 18 weeks of gestation through the first 30 days after birth. Other terms for this age period include fetal, prenatal, in utero for the period before birth. Neonatal and newborn for birth through one month of age.
    • Childhood, ages 1 month to 18 years  
  • Recognition of stroke is often delayed or even missed in children.
  • Stroke is as common as brain tumors in the pediatric population.
  • Stroke is one of the top ten causes of death for children.
  • Of children surviving stroke, about 60% will have permanent neurological deficits, most commonly hemiparesis or hemiplegia. Hemiplegia/hemiparesis (total or partial paralysis on one side of the body) is the most common form of cerebral palsy in children born at term, and stroke is its leading cause.
  • Other long-term disabilities caused by a stroke in childhood include cognitive and sensory impairments, epilepsy, speech or communication disorder, visual disturbances, poor attention, behavioral problems, and poor quality of life.      
    Perinatal Stroke facts
  • The majority of pediatric strokes occur in the perinatal period.
  • To many people’s surprise, the most focused period of risk for ischemic stroke in your lifetime is the week you are born.
  • In most perinatal strokes, a cause cannot be found.
  • For perinatal strokes, the overall risk for another stroke is extremely low, < 1%.
  • Showing a hand preference, or consistently reaching out with only one hand before 1 year of age may be an indication of an earlier perinatal stroke.
  • When stroke affects a newborn infant, symptoms may not appear until 4 to 8 months of age in the form of decreased movement or weakness of one side of the body.
  • Cerebral Palsy (CP) refers to a motor (physical movement) difficulty which results from an abnormality or injury to the brain before or around the time of birth. Therefore, for stroke, the term CP only applies to perinatal stroke. The term CP is not correct for childhood stroke though many children share similar neurological problems (i.e. weakness on one side).
    Childhood Stroke facts
  • For children who have an initial stroke, the risk for recurrent strokes is between 15% and 18%.
  • Early recognition and treatment during the first hours and days after a stroke is critical in optimizing long-term functional outcomes and minimizing recurrence risk.
  • Many children with stroke symptoms are misdiagnosed with more common conditions that mimic stroke, such as migraines, epilepsy or viral illnesses.

 Risk Groups

  • Newborns, especially full-term infants
  • Older children with sickle cell anemia, congenital heart defects, immune disorders or problems with blood clotting
  • Previously healthy children who are found to have hidden disorders such as narrow blood vessels or a tendency to form blood clots easily
Signs and Symptoms

The most common signs and symptoms of stroke include the sudden appearance of:

In Children and teenagers

  • Weakness or numbness of the face, arm or leg, usually on one side of the body
  • Trouble walking due to weakness or trouble moving one side of the body, or due to loss of coordination
  • Problems speaking or understanding language, including slurred speech, trouble trying to speak, inability to speak at all, or difficulty in understanding simple directions
  • Severe headache especially with vomiting and sleepiness
  • Trouble seeing clearly in one or both eyes
  • Severe dizziness or loss of coordination that may lead to losing balance or falling
  • New appearance of seizures, especially if affecting one side of the body and followed by paralysis on the side of the seizure activity
  • Combination of progressively worsening non-stop headache, drowsiness and repetitive vomiting, lasting days without relief
  • Complaint of sudden onset of the "worst headache of my life"

In Newborns and infants

  • Seizures
  • Extreme sleepiness
  • A tendency to use only one side of their body
Sources: Children's Hospital of Philadelphia, Pediatric Stroke Program, "About Pediatric Stroke"
Calgary Pediatric Stroke Program, "Pediatric Stroke: Definitions and Terminology"
List of Specialists 
  • Pediatrician - a community-based child health specialist, can often help coordinate multiple issues with child’s general health
  • Rehabilitation Specialists -  includes doctors such as physiatrists and developmental pediatricians with expertise in child rehabilitation
  • Physical Therapist - assists in reaching the child's maximum potential to function, facilitates motor development, improves strength and endurance
  • Occupational Therapist - works with the child to enhance participation in everyday activities, play and sports, and return to home or school
  • Speech Language Pathologist - for assessment and help with speech or language challenges
  • Neuropsychologist - for assessment and help with learning and education needs
  • Psychologist -  can assist with the psychological stresses in both child and family that are common in perinatal stroke
  • Orthopedic Surgeon - expert in the “mechanical” complications of stroke such as tightness in the arm or leg that might be helped by surgery
  • Hematologist -  a blood specialist who helps with testing for blood clotting disorders or occasional rare causes of stroke in children
  • Neonatologist -  a pediatrician expert in newborn care is usually involved early in the care of children diagnosed with acute neonatal strokes
  • Neurosurgeon - occasionally involved when certain types of stroke can be helped with surgical procedures
Medical Website Links 
Stroke in Children Good information from IAPS Board Member Dr. Adam Kirton via Child Neurology Foundation
Pediatric Stroke: A Review, from Emergency Medicine International 
Results of the VIPS study
Emerging Subspecialties in Neurology: Pediatric stroke and cerebrovascular disorders 
Childhood Stroke and Behavior Articles, Dr. Jeffrey E. Max:

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