Strokes are rarely associated with children and young people, and yet around 400 children in the UK have a stroke every year. As with adults, the impact of childhood stroke is often devastating. Many children are left with severe permanent physical and mental impairments, and the impact on the wider family is often significant.
Because stroke in childhood is, thankfully, relatively rare - most people and even some healthcare professionals aren't always aware of the signs of childhood stroke. This can lead to delays in diagnosis, treatment and initiation of rehabilitation. That's where the new guidelines from the Royal College of Paediatrics and Child Health and the Stroke Association aim to plug the gap. The first edition of the childhood stroke clinical guideline was published over 12 years ago, and this revised version includes up to date clinical guidelines for healthcare professionals as well as a version for parents, carers and young people.
For healthcare professionals
The new clinical guidelines are the first to be truly multidisciplinary - and should be a useful tool for a range of professionals including therapists, psychologists, ambulance staff as well as those working in education.
As is the case with many conditions, when stroke strikes, quick diagnosis is crucial. So the latest guideline clearly states a scan should be carried out within one hour of arrival at hospital for every child with a suspected stroke.
The clinical guideline also includes details of what tests should be performed, how to diagnose and treat stroke and prevent recurrences. For the first time, the guidelines set out criteria for 'clot busting' treatments for childhood stroke, which are currently routinely considered for adults. The entire rehabilitation pathway, from the initial period in hospital, through to going back home and to school and important periods of childhood transition, are covered in the guidelines.
Many children with symptoms or signs that initially suggest stroke may have other serious neurological disorders and could also benefit from the changes in approach recommended by the guideline. The guidelines therefore provide comprehensive information on how to best manage the long term needs of children, particularly rehabilitation and transitions of healthcare and education
For parents and young people
If parents and carers are able to spot the signs of childhood stroke early and the right medical help is given quickly, there's a chance that some of the long term health effects can be minimised.
It's also important to know what to expect as a parent in terms of long-term rehabilitation and the potential problems that may occur with education and development of your child. Again, these guidelines are designed to help support parents and young people as they live with the after effects of a childhood stroke.
Spotting the signs
Early recognition of stroke is crucial so that children can be directed towards rapid diagnosis and treatment. Most children experiencing a stroke will have similar difficulties to those observed in adults who have strokes, including:
- Weakness of the face, one side of the body and difficulty with speech. These signs have been highlighted as part of the 'FAST' campaign for recognising stroke in adults but apply at all ages.
- Less commonly, childhood strokes may present with seizures or fits affecting one part of the body or, rarely, a new onset sudden severe headache.
- Many children affected by stroke will have non-specific signs of illness, such as a decrease in conscious level or vomiting.
To download clinical guidelines and parents' guide, or read a summary, visit the RCPCH website.