A stroke is a brain injury caused by the interruption of blood supply to the brain. The brain requires constant oxygen, which is provided by the blood. Any changes in the blood flow could restrict the amount of oxygen that reaches the brain, leading to brain cells’ death.
Stroke is not common in teens, but it is not unusual for teens and is actually one of the top ten causes of death in childhood (1). The prognosis of the condition is often fatal when the diagnosis and management is delayed.
Read this post to know more about the causes, risk factors, symptoms, diagnosis, treatment, complications, and prevention of strokes in teens.
Causes And Risk Factors For Stroke In Teenagers
Any blockage or delay in the blood supply of the brain may result in a stroke. If the brain’s blood supply is interrupted by a blocked blood vessel, it is called ischemic stroke, and if it occurs due to a bleeding in the brain, it is called a hemorrhagic stroke.
If the blood supply to the brain is temporarily blocked, teens may experience a mini-stroke (transient ischemic attack or TIA). In such cases, teens may have stroke-like symptoms that usually resolve within the next 24 hours. If the symptoms and disabilities are minimal, it is called a minor stroke. A minor stroke may still require further evaluation to prevent recurrent strokes.
The following conditions may increase the risk of stroke in teens (2).
- Heart diseases
- Head injuries and other injuries
- Blood disorders such as sickle cell disease and thalassemia
- Metabolic disorders
- Infections such as encephalitis and meningitis
- Congenital disabilities (birth defects)
- Hypertension (high blood pressure)
- Genetic disorders
- Blood clotting issues
- Blood vessel anomalies, such as vasculitis and dissection
Some teens may develop strokes without any known risk factors and causes. However, teens with known risk factors should take necessary precautions to prevent stroke.
Signs And Symptoms Of Stroke In Teenagers
The signs and symptoms of stroke may vary depending on the underlying cause, severity, and the part of the brain involved. Teens may have stroke symptoms similar to adults. These may include (3):
- Altered mental state
- Severe headache
- Tendency to use only one side of the body or the inability to use one side of the body
- Vision problems, such as blurred vision and eye movement problems
- Swallowing difficulties
- Mood or behavior changes
- Numbness or weakness on the face, a part of the body, or one side of the body
- Loss of balance and coordination often resulting in walking difficulties
- Issues with speech and language
- Loss of consciousness
Stroke symptoms and signs can be easily remembered by the acronym FAST, and you may call emergency medical care if your child has these symptoms.
- F for face drooping. A common sign of stroke is drooping or numbness of one side of the face, resulting in uneven smiles.
- A for arm weakness. Weakness or numbness of one arm is seen in most cases. A teen may not be able to lift the arm, and the affected arm drifts down while they try to lift it or the inability to actively move one side of the body.
- S for speech difficulties. Slurred speech could be due to stroke in otherwise normally speaking teens. They may even fail to repeat simple sentences in severe strokes.
- T for time to call emergency care (911). You may note the time of the symptoms and contact emergency medical care even if the symptoms mentioned above go away.
The acronym can be particularly useful if your teen has known risk factors, such as heart problems. Early medical care and intervention could improve the outcome.
Complications Of Stroke In Teens
Severe strokes that last for a longer time may cause permanent brain damage. Mini-strokes usually may not cause any permanent disabilities. The following complications due to brain damage may occur in some teens (4).
- Cognitive impairment
- Paralysis or weakness of a part or side of the body
- Severe vision problems
- Language and communication issues
- Memory-related issues, such as memory loss
- Psychological problems
The severity and type of complication may vary based on multiple factors, including the type of stroke, part of the brain affected, and the time taken to commence emergency treatment.
Diagnosis Of Stroke
Analysis of symptoms and health history can be the initial step in diagnosing stroke in teens. Doctors may ask a few questions to identify or exclude the possible causes. A set of physical examinations, including neurological examination and visual examination, is done to determine the part of the brain affected.
The following tests are ordered to confirm the diagnosis of stroke (1).
- Brain imaging, such as computed tomography (CT) scan and magnetic resonance imaging (MRI) scans, help visualize the brain.
- Magnetic resonance angiography (MRA) and digital subtraction angiography (DSA) are diagnostic imaging techniques to assess abnormalities of the brain’s blood vessels.
- Blood tests are done to look for infection and inflammation markers, clotting problems, metabolic conditions, and genetic conditions, such as sickle cell disease.
- Lumbar puncture (spinal tap) is often performed to evaluate the cerebrospinal fluid (CSF) and look for brain infections.
- Electroencephalography (EEG) is often ordered to analyze the brain’s electrical activity, especially if your teen has seizures.
- Echocardiography to visualize cardiac structure and function and electrocardiography (ECG) to look for heart rhythm are done to check for heart problems, which are a common cause of stroke.
- Pulse oximetry is performed to ensure that there is enough oxygen in the blood.
These are necessary examinations to identify the underlying cause and location of the stroke. However, healthcare providers may order additional tests, depending on various factors, such as the symptoms and results of other tests.
Treatment For Stroke In Teens
You may call emergency medical care if your teen has signs of stroke since early interventions are most effective. The following treatments could be given depending on the severity, cause, and type of stroke (1).
- Oxygen supplementation
- Antiepileptic (anti-seizure) medications for teens who have seizures
- Medications to eliminate blood clots
- Blood thinners
- Blood transfusions
- Surgery for brain injuries or to correct heart defects
- Repair of affected blood vessels
Most teens recover from a stroke without complications if they receive necessary and timely medical care. Teens may require special care for movement, learning, behavioral issues, speech, and vision after the initial stabilization treatment. Speech therapists, psychiatrists, physical therapists, and occupational therapists can train your teen to overcome these issues.
Prevention Of Stroke In Teens
Stroke may not be preventable in all cases. However, children with known risk factors could follow necessary precautions to avoid stroke. Appropriate treatment of clotting disorders and sickle cell anemia may reduce the risk of these conditions.
Cardiovascular check-ups and regular medications for teens with heart problems may help prevent cardiac reasons for stroke. Teens who had a history of stroke must take the prescribed medications to avoid a second stroke.
Although there is no way to fix dead brain cells, children and teens may achieve normal abilities through adequate rehabilitation. Brain retraining could help the teen perform normal functions, such as speaking, after a stroke. The retraining process can be challenging and slow but mostly has positive outcomes when observed diligently. Constant encouragement and support from parents and other people could help make the road to recovery easier for the teen.
2. Pediatric Stroke Type, Causes, & Symptoms; Children’s Hospital Pittsburgh
3. Stroke In Children; Lucile Packard Children’s Hospital Stanford
4. Complications After Stroke; American Heart Association
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