If your child has had a stroke, our Pediatric Stroke Program provides follow-up evaluation, treatment and help with recovery.

We also help children who are at risk of stroke.

We offer:

• Oregon’s only pediatric stroke program: Your child will get care from doctors who specialize in childhood brain and blood diseases.
• Specialty care: You’ll have access to more specialists who can tailor treatment to your child, including experts in OHSU’s stroke program. They can help improve recovery and prevent strokes.
• Access to research: We take part in the International Pediatric Stroke Study and other research studies. We work with pediatric stroke experts outside OHSU.

Understanding pediatric stroke

A stroke happens when blood flow to the brain is reduced or blocked. Not enough blood flow means not enough oxygen. This can damage the brain and/or nervous system.

A stroke can also be caused by bleeding in the brain.

Pediatric strokes are rare. About five in every 100,000 children have strokes each year.

Risk factors

• Congenital heart defects: A child whose heart is structured differently can be more likely to have blood clots and strokes.
• Sickle cell disease: In this condition, red blood cells make abnormal forms of a protein called hemoglobin. Children with sickle cell disease are 10 times more likely to have a stroke than other children.
• Moyamoya disease: This disorder causes blood vessels in the neck (carotid arteries) to become blocked. This hinders blood flow to the brain.
• Infections: Meningitis, chickenpox and other infectious diseases are linked to higher risk of pediatric stroke.
• Vascular (blood vessel) injury: Clotting or stroke can sometimes be caused by a fall or accident that damages blood vessels or causes them to swell.

Evaluation

If you think your child is having a stroke, call 911 or go to the nearest emergency room. OHSU Doernbecher Children’s Hospital provides 24-hour pediatric emergency care.

Your child may have tests that include:

• CT scan or MRI, to look for bleeding or other problems in the brain.
• Angiogram, to check blood vessels and blood flow.
• Ultrasound of the arteries, to check for narrowing or clots.
• Echocardiogram or electrocardiogram, to look for heart problems.
• Electroencephalogram, to check for seizures.
• Blood tests, to measure clotting ability and check for muscle damage.

Children who are seen at Doernbecher for a stroke stay at least 24 hours in the Pediatric Intensive Care Unit (PICU). This is to check whether:

• Their blood pressure is stable.
• Treatments are working.
• They are having new or worse symptoms.

Treatment

Children may need medications to:

• Reduce the risk of another stroke.
• Reduce the risk of seizure.
• Help manage underlying conditions.

Options include:

• Blood thinners: These medications help keep clots from forming or growing. 
• Tissue plasminogen activator (tPA): This medication helps break up blood clots.

Another treatment option is endovascular treatment, which removes a clot from a blood vessel.

If a medical condition led to the stroke, your child may be given medication or have surgery or other treatment.

Complications

A stroke typically causes permanent damage to the brain. Sometimes a child may recover completely. Other times a child may have:

• Thinking delays
• Problems with senses, such as seeing or hearing
• Speech or communication problems
• Behavior challenges
• Cerebral palsy (difficulty walking or using the arms)

Learn more

• Stroke in Children, American Stroke Association
• Moyamoya Disease, National Institute of Neurological Disorders and Stroke

Resources

• Children’s Hemiplegia and Stroke Association
• International Alliance for Pediatric Stroke
• International Pediatric Stroke Organization

Darrick Stiff