How does the incidence of stroke in children differ from that in adults? Know here

A stroke is a severe brain injury which develops as a result of an interruption of blood flow to part of the brain and may lead to cell death in the brain if not treated quickly. Stroke occurs in two basic forms which include ischemic stroke whose cause is blockage within the blood vessel, and haemorrhagic stroke whose cause is bleeding inside the brain. Though stroke is a disease commonly encountered in adults, it also occurs in children; however, the differences between the occurrence, symptoms, and risk factors of adults and children are great.

How stroke in children differ from that in adults

When we asked Dr Rajnish Kumar, Principal Director, of Neurology, Max Super Speciality Hospital, Dwarka, about the differences, he said that strokes are much more common in adults than in children. Adults have more prominent risk factors like hypertension, smoking, diabetes, and age, especially after 55. In the case of children, though strokes are much less common, they are often associated with different underlying causes. Since stroke is an unexpected condition in children, diagnosis may be late or even a challenge and sometimes symptoms result. However, children have better recovery opportunities than adults, given that their brains are still in the developing stage, which might allow better adaptation after injury.

Another main cause of death in infants is stroke, with the highest risk of stroke occurring within the first year of life and particularly within the first two months of life. The stroke that an infant sustains is referred to as neonatal stroke, and this condition has been estimated to affect approximately one in every 4,000 live births. Stroke can also occur before birth. Symptoms of newborn stroke are often marked by a seizure in which there may be an involvement of only one arm or leg, which is particular to infant stroke and is greatly different from adults who rarely present with seizures as an indicator of a stroke. According to research, approximately 10% of full-term newborn seizures are due to the occurrence of stroke in the neonate.

Specific risk factors and medical conditions increase the likelihood of stroke in children: 

Some of the common underlying conditions that this condition comes with include sickle cell disease and congenital or acquired problems with the heart. The risk factors for this condition may also include head and neck infections, systemic conditions like inflammatory bowel disease and autoimmune disorders, head trauma, and dehydration in children. More than half of all children having a stroke have an identified risk factor, and for many more, at least one or more risk factors can be identified after such an evaluation.

Infant strokes have sometimes been casually linked to conditions that ail the mother or pregnancy complications. Some possible risk factors for mothers include having a history of infertility, a diagnosis called chorioamnionitis infection in the fluid surrounding an unborn baby; premature rupture of membranes; and preeclampsia blood pressure related to pregnancy. These all can set an environment that carries a higher risk for a newborn stroke.

For instance, in children of advanced age, the risk of stroke tapers off after babyhood but may still be experienced especially in the presence of pre-existing conditions. In adults, common risk factors for stroke include hypertensive illness, cigarette smoking, artery disease, diabetes, and atrial fibrillation. Sickle cell disease, however, presents as a predisposing factor that has been associated in cases with adults and children and enhances the chance of blood clotting which could easily cause the loss of the blood supply to the brain.

Although rare in children, strokes are a significant concern because children's symptoms, causes, and recoveries differ significantly from those of adults. 

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