Strokes in Children: What Parents Should Know

Many might picture a stroke patient as middle aged or elderly, but the reality is that the ailment occurs in people of all ages, a CHOC Children’s neurologist says.

A stroke happens when blood flow to the brain stops, and many types exist, Dr. Sharief Taraman says.

Dr. Sharief Taraman

  • Ischemic strokes, most common in children, prevent oxygen and nutrients from reaching the brain. This causes brain cells to die, and can result in permanent damage to the brain and body’s functioning.
  • In hemorrhagic strokes, which are uncommon in children, the blood vessel breaks, which floods the brain with blood and damages brain cells.
  • Perinatal strokes occur in babies near their time of birth, usually during delivery or right after birth because the infant lacked oxygen during delivery.

Stroke causes

Each year, between six and 13 of every 100,000 children will experience a stroke, and they are most likely to happen between a woman’s 28th week of pregnancy and one month after birth.

In older children, strokes are often caused by another condition that can affect blood flow to the brain, Dr. Taraman says. The largest risk factors for stroke in children include heart disease (19 percent), blood clotting disorders (14 percent) and dehydration (11 percent).  About a quarter of young stroke patients have a combination of risk factors.

Further, children with some, few or no vaccinations are more than seven times more likely than fully vaccinated children to have a stroke, Dr. Taraman says. This is likely because many vaccine-preventable illnesses, such as chicken pox, can injure the brain’s blood vessels.

Girls who have migraine headaches that show symptoms before pain begins – a type called “migraine with aura” – are also at a higher risk of stroke. Clinicians are still working to understand the connection fully. There is evidence, however, that some types of oral contraception can exacerbated the migraine-stroke risk. Patients should discuss the risks with their physician when selecting a medication, Dr. Taraman says.

What to look for

Signs of stroke vary widely in children, depending on their age and the resulting brain cell damage. Symptoms include slurred speech, blurred vision, memory loss or sudden weakness.

Children who have experienced a perinatal stroke sometimes tend to favor one hand more than the other. They may also grow normally, but development may occur at a much slower pace than other children. Those whose strokes caused more substantive brain damage may also experience seizures. Often, signs of perinatal stroke don’t materialize until months or years later.

It’s important that children who have experienced a stroke get medical treatment as quickly as possible. Parents who suspect their child has had a stroke should see a doctor immediately or call 911.

Stroke diagnosis, treatment

Strokes can be difficult to diagnose because their symptoms can be subtle and patients who have strokes often have another illness, Dr. Taraman says. To diagnose strokes, physicians rely on blood tests and a variety of imaging techniques.

Treatment varies among patients. Those who are diagnosed during the episode can receive medication that can off-set potential damage. Others may receive treatment for the underlying condition, such as a heart problem, or a resulting condition, such as seizure.

Regardless, children also require extensive rehabilitation that includes neuropsychology; developmental monitoring; educational intervention; and physical, occupational, and speech therapies. Most of the functional recovery occurs in the first two to three months after the stroke.

CHOC has a collaborative team to treat pediatric stroke aggressively. Learn more about the CHOC Children’s Neuroscience Institute.

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Drs. Sharief Taraman, Jonathan Romain Discuss Concussions

Even minor concussions can cause lingering symptoms, two CHOC Children’s specialists tell “American Health Journal.”

Concussions can cause physical effects like headache and nausea, as well as emotional symptoms such as irritability and easy frustration, say Dr. Sharief Taraman, a pediatric neurologist, and Dr. Jonathan Romain, a neuropsychologist.

Learn more about concussions, including prevention, in “American Health Journal,” a television program that airs on PBS and other national network affiliates that reach more than 40 million households.

Each 30-minute episode features six segments with a diverse range of medical specialists discussing a full spectrum of health topics. For more information, visit www.discoverhealth.tv.

Sharief Taraman, M.D., attended medical school at Wayne State University School of Medicine and went on to complete residency training in pediatrics and pediatric neurology at the Children’s Hospital of Michigan. Jonathan Romain, Ph.D., completed his pre-doctoral internship at Franciscan Hospital for Children in Boston and a two-year APA accredited fellowship in pediatric neuropsychology at Medical College of Wisconsin.

More posts about concussions:

Thank you, Parents and Families!

As I help CHOC Children’s celebrate its 50th anniversary, the overwhelming feeling for me and many I’ve met around the hospital is gratitude.

For me, I’m grateful for the care I received when I fell out of that tree in 1964 and the friends I’ve made ever since. So many patients I’ve met are thankful for the bright futures and milestones they’ve achieved thanks to CHOC’s care.

And CHOC’s physicians are no exception. They’re grateful for the trust that parents and families instill in them each and every day. In this video, CHOC physicians express their gratitude.

Kids and Concussions: Learn How to Play it Safe

boy playing soccerUNDERSTANDING CONCUSSIONS

“The word concussion comes from the Latin word to shake violently. It’s a force that causes a temporary injury to the brain or spinal cord,” says Dr. Taraman. “A lot of times, people may hit their head and don’t realize it was
a concussion.”

Signs of concussion may include:

  • Forgetfulness
  • Confusion
  • Loss of consciousness

PLAY IT SAFE

If a child is injured during a sports practice, parents and coaches should make sure the young athlete stops playing. “The child needs to avoid any further hits, jolts, shakes or bumps to the head or spine,” says Dr. Taraman. “Make sure they don’t go back [in the game] and get a second hit. Not only is it unsafe, it’s going to make the recovery take longer and affect the child.”

SIDELINE TIME

“The vast majority of concussions will resolve themselves and heal relatively well,” says Dr. Taraman. After being diagnosed, parents should follow the Graduated Return to Learn & Play Guidelines advised by their doctor. This includes “slowly ramping up from a total rest period of 24 to 48 hours not visiting social media, texting, etc so the brain can heal,” says Dr. Taraman.

The guidelines include five stages of activity levels, such as:

  • No physical activity
  • Sports-specific exercise
  • Non-contact training drills

FAST FACTS

  • How many hours should a child rest after an on-field head injury: 24-48
  • What is the number of sports-related concussions that occur every year in the U.S.: 30,000
  • What is the percentage of sports-related concussions involving children between the ages of 8 and 13: 40%

View the full feature on Kids and Concussions

Dr. Sharief Taraman
Dr. Sharief Taraman
CHOC Neuroscience Institute

PHYSICIAN FOCUS: DR. SHARIEF TARAMAN

Dr. Taraman is a pediatric neurologist and assistant professor at University of California, Irvine. He specializes in concussion management.

Dr. Taraman’s philosophy of care: “I love pediatrics. My daughter was born my first day of medical school. I try to help parents understand the balance of the risks and benefits of participating in sports.”

EDUCATION:
Wayne State University School of Medicine
University of Michigan (B.S., Biochemistry)

BOARD CERTIFICATIONS:
Neurology with special qualifications in child neurology

More about Dr. Taraman | More about the CHOC Neuroscience Institute

This article was featured in the Orange County Register on September 30, 2013 and was written by Shaleek Wilson.

Dr. Sharief Taraman Talks with AM830’s Travis Rodgers about Sports and Concussions

Travis Rodgers, host of the Angels AM830 morning radio show “The Travis Rodgers Show” broadcast live from Seacrest Studios at CHOC Children’s during “CHOC Week”. In this interview, Travis speaks with CHOC Children’s Pediatric Neurologist Dr. Sharief Taraman about concussions in sports, their long term effects, and how children are particularly vulnerable to serious injury. Dr. Taraman explains how concussions can happen in any sport, not just football, and how kids (and their parents) need to weigh the risks and benefits before playing contact sports.

Enjoy the show.

Learn more about the concussion program at CHOC Children’s.

Click here for more CHOC Radio episodes.