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| |  Heart And Stroke Researchers Break New Ground In Pediatric Stroke TORONTO, ON -- August 9, 2001 -- You don’t expect children to have strokes, but according to Heart and Stroke Foundation researchers, this is exactly what happens every year to at least 270 Canadians under the age of 19. The report, results from the Canadian Pediatric Ischemic Stroke Registry involving all 16 children’s hospitals across the country, was published in the August 9 edition of the prestigious New England Journal of Medicine. In the report, which was funded largely by the Heart and Stroke Foundation, authors Drs. Gabrielle deVeber and Maureen Andrew evaluated children with strokes caused by blood clots blocking veins in the brain (most strokes occur in the arteries, instead of the veins). Results from the registry show that every year there are 6.7 such strokes for every 1,000,000 children under the age of 19. Forty-three percent of these strokes occur within the first month of life. "In children, this kind of stroke is usually secondary to one or more underlying diseases or condition," explains Dr. deVeber, who is a Stroke Investigator of the Heart and Stroke Foundation. "In neonates (less than one month), for example, a venous stroke can be the result of infections or perinatal complications in which the fetus experienced at or following birth. In older children, diseases such as cancer or heart disease may be involved. In nearly a third of the children, we found blood clotting disorders, some of which were genetic but most of which were the result of other diseases or ongoing medical treatments for those other diseases." The Heart and Stroke Foundation advises all parents to be aware of the warning signs of stroke and to seek immediate medical attention, regardless of the age of the child. In older infants, children and adolescents, the signs and symptoms of stroke are similar to those of adults, including decreased level of consciousness, sudden headache, paralysis, visual problems, and loss of speech or trouble understanding speech. In adults, stroke is associated with risk factors such as smoking and high blood pressure. In children, the causes of stroke - particularly these venous strokes - are quite different. In very young infants, the warning signs are primarily seizures and diffuse neurological symptoms such as decreased level of consciousness and headache. "The bad news," reports Dr. deVeber, "is that stroke is often the last thing parents and doctors think about when a child presents these symptoms. We are so used to stroke being considered a disease of old age that we tend to assume that the problem must be something else. It is important that the message gets out loud and clear - children can and do have strokes." According to Drs. deVeber and Andrew, there is also good news in today’s report, in that the long-term outlook appears optimistic. Only 8 percent of the children in the study died within the follow-up period. And after an average of 1.6 years, over half (54 percent) had no apparent lasting effects from their illness. Of the 38 percent of children in the study who were left with a neurological deficit from their stroke, 80 percent had restrictions to their ability to move or make movements (motor deficits). Lasting effects on the ability to think (cognitive deficits), to learn (developmental delay), speak and see were experienced by 10 percent or less. The study also shows that progress is being made in the treatment for Canada’s youngest stroke patients. Mirroring advances in the treatment of adult stroke patients, this is 53 percent of the children in this study were given anti-coagulant drugs. None of the children treated with the anti-coagulant drugs died or suffered complications because of their treatment. Although the use of blood thinners in children with sinovenous thrombosis is still considered experimental and practice standards are in development, these results are giving physicians and researchers renewed hope that they are on the right track. "We still have a long way to go in preventing and treating childhood stroke," admits Dr. deVeber who is also a clinician-scientist at the Hospital for Sick Children’s Research Institute. For example, only with more research will children have access to the clot-busting drugs which are now available to adults." According to the Heart and Stroke Foundation, the warning signs of stroke include: sudden paralysis, weakness or numbness of the arm, face or leg; sudden trouble speaking or understanding speech; sudden loss of vision, particularly in one eye or double vision; sudden, severe and unusual headache; and sudden dizziness or loss of balance, especially with any of the above signs. The Foundation recommends that if you or someone you know is having any of these signs, you should call 911 or your local emergency number immediately. SOURCE: Heart and Stroke Foundation Related Link: New England Journal of Medicine.
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