Stroke is not just an adult condition. In the US, it occurs in 4 out of 10,000 newborns and 3 out of 100,000 children per year. According to experts, about 200 newborns born in Brooklyn will suffer from a stroke this year, and about 40 children will have a new onset stroke.
Under the leadership of Dr. Steven Pavlakis, Director of Pediatric Neurology at the Maimonides Infants and Children’s Hospital, a world-class Pediatric Stroke Service has been established. Considering that more babies are born at Maimonides than at any other hospital in the state of New York, this is a vital service for the patients and communities of Brooklyn.
“We’ve assembled an impressive team,” said Dr. Pavlakis. “Being part of an accredited Children’s Hospital means that all of the subspecialties are right here – working together to provide the best possible care for our young patients.”
The team of experts is multi-disciplinary and includes the renowned interventional neuroradiology and pediatric neurosurgery divisions, in addition to pediatric neurology. Rounding out the team are specially trained nurses and therapists who help ensure the best rehabilitation and recovery for each patient.
Strokes in children – unlike in adults – are mostly caused by birth defects, infections, trauma, and blood disorders such as sickle cell disease. Perinatal stroke occurs between 28 weeks of gestation and one month following birth. Childhood stroke occurs between one month and eighteen years of age, though it is more likely to occur in children under the age of two. During and shortly after delivery, babies can be at risk for stroke if there is a problem with the brain getting enough oxygen, a risk that is higher for premature babies.
Fortunately, newborns and children receive the most advanced assessment and treatment at the Maimonides Pediatric Stroke Service. One invaluable diagnostic tool being utilized is the Transcranial Doppler, an ultrasound machine that measures blood flowing though the arteries at the base of the brain. It’s a painless and relatively quick technique that assesses the risk of stroke.
Because of the reputation for excellence of the Maimonides Pediatric Stroke Service, Dr. Pavlakis and his associates were selected to participate in four national studies. Two of the studies are under the auspices of NINDS (National Institute of Neurological Disorders and Stroke), a branch of the National Institutes of Health, and deal with the development of clinical tools that predict outcomes in children with stroke. Other studies, Baby Hugs and SWITCH, focus on sickle cell disease and are funded by the NHLBI (National Heart, Lung and Blood Institute).
The Maimonides Pediatric Stroke Service has been approved to develop a genetic database at the NIH repository for pediatric stroke, which will be the only genetic research effort in pediatric stroke in the world. To further enhance research and treatment of stroke in children, Maimonides is a founding member of the International Stroke Group, and its stroke experts are the founders of the New York Stroke Group.
Stroke symptoms in babies and children include: severe headache, speech difficulties, eye movement problems, and numbness. The National Stroke Association offers a helpful tool to help you remember these symptoms and respond quickly. It’s an acronym – FAST – and signifies face, arms, speech, and time. When you suspect a stroke is occurring, ask the child to smile, raise both arms, and repeat a simple sentence. If one side of the face droops, one arm drifts downward, the words are slurred or the sentence is not repeated correctly, call 911 immediately.
Disabilities that occur as a result of stroke in children can differ from those in adults. According to the National Stroke Association, babies who have strokes in the womb or during the first month of life are at risk for cerebral palsy. In addition, mental retardation, epilepsy, and other complications can occur. Both children and adults who suffer a stroke may have problems with speech and communication, paralysis or weakness on one side.
Stroke treatments given within the first three hours after the onset of stroke symptoms are the most effective. As with adult stroke, every minute counts. Dr. Pavlakis urges rapid response after the onset of stroke symptoms. For more information on stroke in children, visit the Maimonides website at www.maimonidesmed.org.
