The team from Seattle Children’s Pediatric Vascular Neurology Program treats babies, children and adolescents who have had a stroke.
Some patients start by coming to our Emergency Department during or immediately after a stroke. Some are transferred to us from other hospitals that provide emergency care. These children may need to stay in the hospital, possibly in our pediatric intensive care unit (ICU) or Level IV neonatal ICU.
Some children are referred for a clinic visit by their primary care provider or another specialist. Reasons for referral include:
- Symptoms that suggest a stroke in the past
- Follow-up care after a stroke
- A condition that increases the risk for stroke
Stroke Treatment Options
Treatment for perinatal stroke and childhood stroke depends on:
- The type of stroke
- The short-term and long-term effects of the stroke
- Any underlying condition that caused the blockage or bleeding in your child’s brain
Your child’s treatment and the members of their stroke team will be tailored to their needs. The main goals are:
- To stop further damage from the stroke
- To help your child recover as fully as possible
- To prevent future strokes or related health problems
Whatever the cause or effects of your child’s stroke, a diagnosis of stroke can be overwhelming. Support is an important part of care for you and your child at Seattle Children’s.
Medicine for Stroke
If a blood clot is blocking blood flow in your child’s brain (ischemic stroke), doctors may use blood thinners (antithrombotics, either antiplatelets or anticoagulants) to keep clots from getting larger and to prevent new clots.
Supportive care is care meant to prevent or reduce symptoms of a condition or side effects of treatment. For pediatric stroke, supportive care often means using medicines to:
- Control seizures
- Prevent or treat fever
- Reduce swelling in the brain
These measures may help protect brain cells in the penumbra that are damaged but still alive.
In general, tissue plasminogen activator (tPA), a medicine that dissolves clots, is used in children only as part of a clinical trial. This drug is widely used in adults in the hours right after an ischemic stroke. Doctors are still studying how it affects children and which children can benefit.
Surgery for Stroke
If an artery in your child’s brain is bleeding (hemorrhagic stroke), a neurosurgeon may have to surgically repair the artery.
Surgery may also be done to:
- Drain extra blood that leaked from the blood vessels and built up in the brain
- Open the skull to decrease pressure on the brain caused by bleeding or swelling
- Drain extra cerebrospinal fluid (CSF) around the brain through a shunt in children with cerebral venous sinus thrombosis
Treating the Cause of Stroke
If your child has an underlying condition that might have caused the stroke — and might put your child at risk for future strokes or other health problems — doctors will recommend treatment for this condition. Based on the condition, treatment may include:
Ongoing Care and Support
After your child receives any urgent or emergency treatment they need for stroke, the team at Seattle Children’s plans and provides the ongoing care your child needs to have the best possible outcome. We evaluate all your child’s health needs and customize care to your child and family.
Many, but not all, children have some lasting effects of their stroke (neurologic deficits). The effects may depend on the part of the brain that was damaged. To decrease lasting effects, ongoing care typically involves rehabilitation, such as occupational therapy, physical therapy and speech and language services.
For any learning, social or behavioral problems, your child may benefit from Rehabilitation Psychology, Neuropsychology and Psychiatry and Behavioral Medicine.
The Seattle Children’s stroke team is experienced in helping children return to school and other important activities after stroke.
Social support can be very important for families dealing with stroke. You are not alone. We will help you cope with the effects of your child’s stroke and connect you with resources, such as Pediatric Stroke Warriors, International Alliance for Pediatric Stroke and Children’s Hemiplegia and Stroke Association.
When your child is older and ready to transition to adult care, we work closely with the UW Medicine Stroke Center at Harborview Medical Center to help ensure your child continues to get comprehensive, customized care. Many of the doctors who treat stroke at Seattle Children’s also treat stroke in adults at Harborview.
Preventing Future Strokes
Overall, about 10% of children who have had a stroke will have another stroke in the future. The risk for each child depends on many factors, including the cause of the stroke. Your child’s team will take steps to prevent future strokes and teach you – and your child, when they are old enough – how to reduce the risk.
Common methods to prevent stroke include:
- Drinking water and other fluids each day to keep your child’s blood volume and blood pressure high enough for good blood flow.
- Using medicines that prevent blood clots from forming.
- Avoiding medicines that constrict the blood vessels, such as medicines used to treat a migraine, unless recommended by a doctor who knows about stroke and your child’s health history.
- Using caution with medicines that increase the risk of blood clots, such as birth control pills.
- Making sure your child gets exercise each day and eats a healthy diet, high in vegetables and fruits and low in sodium.
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.