Stroke Program

The risk for stroke is highest during the first year of life, but it can occur any time during childhood or adolescence. It’s important to know the symptoms of stroke, so you can recognize it quickly.

Children tend to recover from stroke better than adults, since their brains are still developing. You can count on us to personalize your child’s care and provide a healing environment for your child and your family.

What Is Stroke?

Stroke is the sixth leading cause of death in children. It happens when blood flow is interrupted to part of the brain, either by a blocked blood vessel (ischemic stroke) or by bleeding in the brain (hemorrhagic stroke). When blood flow stops, brain cells begin to die.

What Are the Symptoms of Stroke in Kids?

It’s important to be alert to symptoms of stroke in children, especially if your child has a higher than average risk for this event. In newborns, stroke symptoms can include:

• Seizures
• Extreme sleepiness
• Altered mental status
• Using only one side of the body

In older children, symptoms can include:

• Seizures
• Neck pain or stiffness
• Headache, possibly with vomiting
• Trouble seeing or moving the eyes
• Sudden weakness or numbness on one side of the body
• Slurred speech or other problems with speaking
• Dizziness or sudden confusion
• Sudden collapse or loss of consciousness
• Difficulty walking

Can Stroke Be Prevented?

Certain conditions make children more likely to have a stroke. These conditions include:

• Heart problems
• Sickle cell disease
• Infections such as meningitis or encephalitis
• Head injury
• Blood vessel abnormalities
• High blood pressure

Treating and managing these conditions can help prevent a stroke. Prevention can include neuroprotective measures such as maintaining adequate blood pressure, supplying fluids and giving your child appropriate mediations.

If your child has had a stroke, your team will work to determine what caused it so they can reduce the risk for a second stroke.

How Is Stroke Diagnosed?

To diagnose stroke in children, doctors ask about their symptoms and their health history. For example, your stroke team may ask if your child has had a recent injury or infection, or if your family has a history of bleeding problems. They also will do a neurological exam to check for weakness, numbness or other stroke signs.

These tests are available 24 hours a day, every day, to help diagnose and manage stroke:

• Brain imaging studies. Magnetic resonance imaging (MRI), computed tomography (CT) scans and other imaging tests can show abnormalities in blood vessels in the brain.
• Blood tests. These can show signs of infection, inflammation of blood vessels, blood clotting problems and conditions that can lead to stroke.
• Heart and blood vessel studies. An electrocardiogram (ECG) checks heart rhythm, and an ultrasound of the heart (echocardiogram) can show possible causes of a blood clot.
• Lumbar puncture, or spinal tap. This test takes a sample of the fluid that surrounds the brain and spinal cord to check for blood or signs of infection.
• Electroencephalogram, or EEG. This test checks for seizures.
• Transcranial Doppler Ultrasound, or TCD. This test assess for changes in cerebral blood flow
• Pulse oximetry. This test checks the oxygen level in the blood.
• Multimodal monitoring. This provides physicians with information about multiple neurological and physiological changes in patients with stroke and other serious neurological injuries.

How Is Childhood Stroke Treated?

If your child has had a stroke, your team will choose the best treatments for the specific type of stroke. If the stroke is from a blood clot (an ischemic stroke), your doctor may use a medicine called tissue plasminogen activator (tPA) to break up the clot.  Aspirin and other blood thinners may also be used, along with special vitamins.

For bleeding in the brain (a hemorrhagic stroke), doctors will work to maintain your child’s fluid balance and body temperature. In some cases, surgery is needed to place a metal clip to stop the bleeding.

Your child may also have other treatments, such as a blood transfusion, oxygen or both. With all these treatments, your child will be closely monitored in the Intensive Care Unit.

Recovering From Stroke

Most children recover well after a stroke. They may need physical therapy, speech therapy and occupational therapy to reach their best recovery. In some cases, a stroke can lead to changes in behavior and emotional control. Your stroke team can recommend treatments for these changes.

What to Expect at Children’s

At Phoenix Children’s, our stroke team at the Barrow Neurological Institute provides individualized care to each child. From diagnosis to rehabilitation, your child and your family are our highest priority.

Each of these services is available 24 hours a day, seven days a week:

• Pediatric Intensive Care Unit (ICU)
• Cardiovascular Intensive Care Unit
• Neonatal Intensive Care Unit
• Emergency Department

Our expert clinicians will also be at your child’s bedside whenever they are needed. This includes specialists who are highly trained in treating children with stroke, such as our pediatric neurologists and our neuro-interventionalists.

Stroke Clinic

The specialists at our Stroke Clinic care for children who have had a stroke or are at risk for one. They include specialists in hematology, vascular neurology and interventional neuroradiology if this is required. We can also call in a Phoenix Children’s physiatrist. These physicians specialize in physical medicine and rehabilitation.

When you and your child come to our Stroke Clinic, our specialists meet before your visit to discuss your child’s condition and develop a comprehensive plan of care. This may include imaging or other testing that we will arrange before your visit.

Our Stroke Clinic is part of the Neurovascular Program at Barrow Neurological Institute’s Phoenix Children’s location. It is co-directed by Dr. Tara Mangum and Dr. Todd Abruzzo.

Meet Your Team

Each member of your stroke team is highly trained and experienced in caring for children with stroke. We use the latest technologies to diagnose and treat stroke in infants, children and teens. Our stroke team includes specialists in a number of related fields, including:

• Pediatric neurologists specializing in stroke
• Pediatric neuroradiologists
• Pediatric specialists in hematology and vascular medicine
• Cardiologists
• Rheumatologists
• Psychiatrists
• Physical, occupational and speech therapists

Your child’s stroke team includes the following specialists:

• Todd A. Abruzzo, MD
• Brian L. Appavu, MD
• Neil R. Friedman, MD
• Christine M. Knoll, MD
• Tara. K. Mangum, DO
• Iris Marku, PNP
• Sanshay Shah, MD
• Priscila Badia Alonso, MD