Why Are Children Getting Stroke? Real Medical Reasons Every Parent Must Know

Paediatric stroke — stroke occurring in children from newborn to 18 years — has an incidence of approximately 1–8 per 100,000 children per year. While rare, it is one of the top 10 causes of death in children, and survivors frequently have significant long-term disability including hemiplegia, epilepsy, and learning difficulties. Unlike adult stroke, the causes in children are diverse — and understanding them helps parents and doctors recognise and respond appropriately.

Causes of Stroke in Newborns (Perinatal Stroke)

Perinatal stroke — occurring around the time of birth — is actually more common than stroke at any other paediatric age. It is typically ischaemic and is often caused by: placental clots travelling to the foetal brain; coagulation disorders in the mother or baby; twin-to-twin transfusion complications; or birth asphyxia. Many perinatal strokes are detected only later when parents notice one-sided hand preference in infancy (a normal infant uses both hands equally — strong preference for one hand before 12 months should prompt evaluation).

Causes in Infants and Older Children

Congenital heart disease: The most common structural cause of childhood ischaemic stroke. Complex heart defects create turbulent blood flow, right-to-left shunts, or clot formation — clots can embolise to the brain. Children with congenital heart disease requiring surgical repair are at particular risk in the perioperative period.

Sickle cell disease: The most common cause of stroke in black African children. Sickled red blood cells cause vaso-occlusion in cerebral vessels. Regular transcranial Doppler screening and hydroxyurea therapy have dramatically reduced stroke incidence in sickle cell disease in countries where it is implemented.

Arteriopathies: Inflammatory or structural abnormalities of cerebral arteries — including Moyamoya disease (progressive stenosis of internal carotid arteries), childhood-onset cerebral arteritis, and focal cerebral arteriopathy. Often idiopathic but respond to specific treatment.

Prothrombotic states: Hereditary clotting disorders — Factor V Leiden, prothrombin gene mutation, antiphospholipid antibodies — predispose children to arterial and venous thrombosis. Often first detected when a child presents with stroke.

Infections: Bacterial meningitis, viral encephalitis, and COVID-19 all cause cerebral vasculitis or thrombosis that can produce stroke in children.

Warning Signs in Children

The same FAST criteria apply in children: Facial droop · Arm weakness · Speech difficulty · Time to call 108. Additional signs in young children: sudden loss of ability to use one hand; a child who was walking normally suddenly falls repeatedly to one side; seizures with one-sided onset; sudden vision loss in one eye.

Paediatric stroke evaluation including MRI brain, echocardiogram, thrombophilia screen: Sri Anand CNC, Chanda Nagar, Hyderabad. Call +91 90633 66983.