“We see many children with stroke. it isn't a rare complication," says Jo Wilmhurst, head of paediatric neurology at the Red Cross Children's Hospital. "Children referred through to a tertiary level neurology service are around one a month, but far more children are managed by general paediatricians."

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He adds that there are no epidemiological figures for the incidence and prevalence of stroke in childhood in South Africa. "We can only estimate the impact of the disability on child health."

Up to 50% of strokes in children are caused by a bleed (haemorrhage) in the brain. Reasons for a bleed happening include the formation of blood vessels in the brain from birth, which may burst and bleed into the brain; a brain infection; severe dehydration; and prolonged low blood pressure or a head injury.

The most common acute or acquired causes of stroke in children are infection related (tuberculosis, meningitis or HIV/Aids), trauma related (car accidents or gunshot wounds), dehydration (caused by severe gastroenteritis) and post-infectious causes (e.g. post-chicken pox).

Signs and symptoms
When asked about the symptoms or signs of stroke in children, Wilmhurst said that it depends on the underlying cause. "For example, if they have tuberculosis meningitis, then they will usually have other problems such as convulsions, depressed level of consciousness, headache and vomiting as well as other problems related to a stroke."

He adds: "If a stroke occurs in the frontal area of the brain, the child may have a change in behaviour or concentration, a more typical weakness down one side of the body and loss of vision in both eyes, but only specific quadrants”.

Children who have developed a stroke may have problems with movement and need the help of a physiotherapist and an occupational therapist. Some children have feeding or speech problems and need support from a speech therapist. Early intervention is important.

Specific medical treatments are a little controversial as the potential complications tend to be greater than the benefits.

Call to action
Nevertheless, the problem of stroke in children and adults need to be addressed on a national level. Studies and research needs to be conducted to determine the prevalence of stroke in South Africa and treatment programmes must be developed.

For more information regarding stroke, kindly contact the Heart and Stroke Foundation on Tel: 021 447 4222.

- (Heart and Stroke Foundation, September 2006)

The Heart and Stroke Foundation South Africa
 

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