Clinical update

Stroke in childhood

Updated guidance from the Royal College of Paediatric and Child Health for health professionals and parents on stroke in childhood. 

The Royal College of Paediatric and Child Health has updated its guidance for health professionals and parents on stroke in childhood

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Essential facts

About 400 children a year in the UK have a stroke. Many are left with severe mental or physical impairment. While there have been improvements in the diagnosis and treatment in recent years, the condition is still not as well recognised as stroke in adults. Experts believe that greater awareness among parents and healthcare professionals could lead to speedier diagnosis and minimise risk of severe long-term health problems.

What’s new

In May, the Royal College of Paediatric and Child Health (RCPCH) published updated guidelines on stroke in childhood. Funded by the Stroke Association, the guidance covers identification, diagnosis management and rehabilitation. Aimed at all healthcare professionals, it includes recommendations to enhance the quality of stroke care for children and young people, and a guideline for parents.

Signs and symptoms

As with adults, the most common symptom is weakness on one side of the body. A child’s face may droop on one side or their speech may be affected. Other signs may include headache, seizures, the sudden onset of vertigo or loss of consciousness. Symptoms can come and go and it may appear that a child has recovered. The FAST (face, arms, speech, time) criteria can be used to identify stroke.

Causes and risk factors

For children and young people, the causes of stroke are often different to adults. Conditions that may increase the risk include: diseases of the blood vessels; cardiac disease and surgery; blood clotting disorders; infections such as varicella zoster virus and upper respiratory tract infections; and illicit drug use. No cause is identified in about 10% of cases.

How you can help your patient

Nurses can support both the child and their family, particularly siblings, who may feel frightened by what has happened. School and community nurses can also be involved in care, educating and preparing a child’s teacher and classmates for their return to school.

Expert comment

Fiona Smith, RCN professional lead for children and young people’s nursing

‘Nursing staff in all settings – including practice nurses, those working in emergency departments and school nurses – need to recognise that children can have a stroke. At the moment, there is not enough awareness among the public or healthcare professionals. We hope that this updated guideline will help to improve knowledge and also boost research into this area, as there has not been much in the past, in comparison to stroke in adults.

‘For a child experiencing stroke, the signs and symptoms are the same as for adults, and they need the same fast treatment. The first hour is crucial. Rehabilitation also needs to be discussed with the family at the point of diagnosis, with parents and the child actively involved in decisions.’  


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