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Childhood Stroke affects about five in every 100,000 children a year in the UK.  The terms covers strokes that occur from the 28th week of pregnancy until the age of 18 years.  This CPD module introduces how the causes and the effects of a stroke depend on the child's age and note that with support many children are able to recover.



After studying this module, you should:

  • Appreciate the epidemiology and causes of stroke in children
  • Recognise the symptoms of stroke in children
  • Be familiar with the management of stroke in children
  • Appreciate the sources of advice and support for children who experience a stroke.


  • Read clinical content
  • Complete CPD assessment
  • Receive learning log for your records
  • Read our clinical review: if you don’t have a printed version, click here to download a pdf


Reviewed by: Michelle Thomas RGN, RHV, MSc, RNP, PGCE







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      Pre-learning reflection

      Please take a moment to answer these pre-learning questions.  Once completed, click 'next step' below to start this module.  These answers will be logged on your CPD certificate which will be emailed to you on completion as evidence of your learning.


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      • Around 400 new stokes in children every year

      • One of the top ten causes of death in childhood
      • Up to two-thirds of children may live with on-going physical, communication and/or cognitive difficulties after a stroke
      • A child's brain is developing; families may have to wait to see a stroke's full development impact

      • Reduced awareness of stroke in childhood - isolating for children and families
      • Different causes to stroke in adults - families may deal with a number of complex health conditions







      Already studied the clinical review? Go straight to the test here
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      Childhood stroke can have numerous causes, including:

      • Heart disorders

      • Blood disorders

      • Infections

      • Vascular disorders
      • Arterial dissection

      • Trauma to the head or neck

      • Sinovenous thrombosis
      • Arteriovenous malformations

      • Aneurysms

      • Cavernous malformations

      • Moyamoya syndrome

      • Vasculitis

      • In up to 10% of cases, the cause may remain unknown
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      Clinical Features

      • May be difficult to recognise, particularly if a child is very young or when the stroke is in the early stages of development

      • May be mild or may not produce physical symptoms; the stroke may not produce physical symptoms; the stroke may cause changes in a child's behaviour or delayed learning
      • May include seizures in babies who are less than 28 days old
      • May be detected gradually when problems arise with learning, development or movement on one side






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      • Call 999 - time is brain

      • Be aware that children can have transient ischaemic attacks (TIA), when the brain's blood supply is interrupted for a very brief time
        - TIA symptoms only last for a few minutes or hours and then completely disappear, usually within 24 hours
      • Even if a child appears to be recovering, this is still a medical emergency: call 999






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      Diagnosis, treatment and support

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      A childhood stroke can cause problems with:

      • Movement

      • Speech

      • Behaviour, vision and hearing

      • Learning and education

      • Mood and confidence

      • Secondary complications (eg seizures or dealing with a new medical condition)

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      Case study: Background

      • Ben is three years old.  He lives with his mum and dad and two brothers.  He is fit and well and has no health issues.

      • Ben goes to nursery three days a week and spends the other two days with his granny.

      • He had chickenpox recently, but appeared to recover well.

      • One day his granny thought Ben was having difficulty walking.  His granny thought this was down to tiredness after a busy day, but told his mum about it when she took her home.

      • When his mum looked at Ben she felt one side of his face was dropping and he was not as chatty as usual.  When she watched him walking, she felt Ben was staggering to one side.
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      What should Ben’s mother do?
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      Case study: Background

      • The family went straight to A&E.  By this stage, Ben was not able to move his right arm or stand unsupported.  He was awake, but seemed confused.

      • Following initial tests the family were told that he was being sent to have a brain scan.  His mum asked why this was necessary.  The doctor said "The problem with his moving may be to do with his brain".

      • The brain scan confirmed that Ben had had a stroke in the left side of his brain.  Ben was transferred to a specialist hospital for further tests.  This hospital was a lot further from where his family lived.

      • The family were advised that it was likely his stroke was linked to his recent chickenpox infection.
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      Which of these suggests that Ben’s stroke has worsened?
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      Case study: in hospital
      and coming home

      • Ben spent a month in hospital: he had seizures in the early days after his stroke and needed therapy and rehabilitation.  His parents stayed with him alternate nights.  His siblings spent most of their time with their granny.

      • His brothers only came to the hospital once, as his parents were worried it might frighten them.

      • Ben has just come home.  He has started to walk again, but needs a splint on his foot and leg.  He gets tired very easily.  Ben is able to move his right arm, but is not yet able to hold objects with his right hand or play using his two hands.  Sometimes, when he plays, his mum thinks he does not notice his toys as much on his right-hand side.  Ben is able to say some familiar words, but is not as chatty as he used to be.  He can get very cross at times.

      • His mum has said: "He was a really relaxed little boy, it is just not like him".  The family have been told it may take some years before the full impact of Ben's stroke becomes clear.
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      How has the stroke affected Ben?
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      Case study: Life after stroke

      • Now Ben is home, he will see the community therapy team, but there is a waiting list.  He still has lots of appointments with the hospital teams and he is taking daily medication to reduce his risk of further strokes or seizures.  His mum reduced the hours she works to spend more time with him and take him to his appointments.

      • Ben's parents have lots of therapy exercises to do with him, but find it difficult to complete them when he is tired or cross.  They have noticed that this brothers are worried about being alone with Ben.  The nursery has told mum and dad that they have never looked after a child who has had a stoke before or who is at risk of a seizure.  This has made mum and dad anxious about Ben returning to nursery.

      • His dad has said: "We feel very alone, we have not yet met any other families whose child has had a stroke"
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      What other issues are the family facing?
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      Sources of support and advice

      • Community paediatrician linking in with GP to maintain an overview of medical status and support needs
      • Community therapy team - physiotherapy, occupational therapy, speech therapy

      • Clinical nurse specialist to give advice to nursery on managing seizures and medication and help with care planning
      • SENCO (Special Educational Needs Co-Ordinator) to start providing advice on supporting Ben in the nursery and with education
      • Social work team or welfare advisory team to provide carer support, review famly finances and transport needs
      • Sibling support or young carer support services

      • Play specialists or child psychology teams to help with mood and behaviour
      • Voluntary sector support services - such as the Stroke Association Child Stroke Support Service - to offer information, advice and support for the family, and help the family find a peer support network






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      Post-learning reflection

      Please take a moment to answer these post-learning questions.  These answers will be logged alongside your pre-learning responses on your CPD certificate which will be emailed to you on completion as evidence of your learning.


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      Stroke Association

      The Stroke Association believes in life after stroke. That’s why the Stroke Association supports stroke survivors to make the best recovery they can. It’s why the Stroke Association campaigns for better stroke care for children and adults. And it’s why the Stroke Association funds research to develop new treatments and ways of preventing stroke for children and adults.

      Stroke Association offers information, advice, support and resources for families affected by stroke in childhood:

      For more information:

      Email: [email protected]
      Helpline: 0303 3033 100
      Stroke Association House,
      240 City Road,
      London, EC1V 2PR