Brain, Nervous System and Mental Conditions
Stroke Symptoms & Diagnosis
Symptoms of stroke tend to be different in newborns (age 28 days or younger) than in older children.
Perinatal stroke symptoms
Seizures are a common symptom of perinatal stroke. They usually start 12 to 48 hours after birth and repeat.
Most newborns with stroke have general symptoms that can also be caused by other conditions. These include:
- Low muscle tone and strength, making the baby seem floppier than normal
- Sleepier than normal (lethargy)
- Briefly not breathing (apnea)
Some babies have no clear symptoms for weeks or months after their stroke. Often parents, caregivers and doctors do not notice any signs of perinatal stroke until age 4 to 6 months, when the baby starts to seem weaker or partly paralyzed on one side of the body (hemiplegia or hemiparesis).
- Baby not moving 1 side of their body as well as the other
- Baby keeping fingers and toes on one side of the body clenched in a fist
- Child clearly using 1 hand more than the other (not common before age 1 in healthy babies)
Childhood stroke symptoms
Children who have a stroke after the perinatal period tend to have 1 or more of these symptoms that come on suddenly:
- Weakness, paralysis or numbness in the face, arm or leg, usually on one side of the body
- Trouble speaking, understanding language, reading or writing (aphasia)
- Changes in vision, such as decreased vision or double vision
- Dizziness, loss of balance or loss of ability to stand or walk
- Sudden, severe headache
- Seizures in a child who has not had seizures before – especially seizures that involve only one side of the body, followed by weakness on that side
To diagnose stroke, the doctor will examine your child and ask about your child’s symptoms and health history. This may include questions about your child’s progress toward common developmental milestones – how they behave, learn and move – based on your child’s age.
Details about your child’s birth, the mother’s health and pregnancy and the family’s health history may also help with diagnosis.
To see pictures of your child’s brain and look for blockage, bleeding or problems with the blood vessels, the doctor may ask for your child to have one or more of these imaging studies:
- CT (computed tomography) scan
- MRI (magnetic resonance imaging) scan
- MRA (magnetic resonance angiography)
- Cerebral angiogram
Seattle Children’s neurologists and neuroradiologists work together closely to plan your child’s imaging studies and diagnose their condition using the results.
Your child may also need one or more of these tests:
- Blood tests to check for clotting or bleeding problems, infection or diseases that might increase stroke risk
- Echocardiogram to check for heart problems
- Electrocardiogram to check for problems with heart rate or rhythm
- Electroencephalogram to look for the cause of seizures
A stroke is a medical emergency. If you think a child is having a stroke, call 911.
For non-emergencies: To make an appointment with a Seattle Children’s provider, you need a referral from your child’s primary care provider or another specialist. If you have a referral, call 206-987-2078.