Alex was a typical 11-year-old boy. He enjoyed playing sports with his friends and being with his family. Then one day his life suddenly changed forever. Alex felt numbness and tingling in his right arm. Hours later, the right side of his face was numb. Alex was taken to the hospital where it was determined that he had suffered a stroke.

Stroke’s challenges

How could this have happened to a young boy? The causes of stroke in children are not well understood. While prompt diagnosis and treatment remains vital to helping improve the outcome in children, we need to understand the underlying mechanisms and pathobiology for pediatric stroke. Since initial stroke is often the first sign of a problem in a child, prevention can be difficult.

“Over 60 percent of children who experience a stroke are left with permanent neurological deficits.”

A few months later, Alex suffered two more strokes, even though he was on medication to prevent them. He went through extensive testing to find the cause for his strokes. Five years later, nothing was ever found. Despite current treatment, 1 in 10 children with an initial stroke will have another stroke within 5 years. Unfortunately, there are a significant number of children who will not have any risk factors identified despite extensive investigation.

For adults, research has shown strong methods for preventing stroke such as managing blood pressure, losing excess weight, lowering cholesterol and not smoking. These techniques rarely prevent childhood stroke because risk factors are much different in children than adults. For children some of the risk factors include congenital heart disease, infections, sickle cell disease and blood clotting disorders. These are typically not preventable conditions.

Stroke during pregnancy

RECURRING RESTRICTION Despite being on preventative medication, Alex still suffered two additional strokes months after his first. Photo: Courtesy of Alex

While strokes can happen during childhood, they can also strike before birth. Mario suffered a perinatal stroke, which occurs during the last 18 weeks of pregnancy through one month of age. The cause of his stroke is unknown, which is typical for most perinatal strokes.

Mario was diagnosed just 10 days after birth, which allowed him to start a rehabilitation program at an early age. Over 60 percent of children who experience a stroke are left with permanent neurological deficits. Mario has the most common deficit, hemiplegia, which is a weakness or paralysis on one side of the body. Five years later, Mario continues to strengthen his left arm and leg with therapy interventions.

Understanding the lack of research for children affected by stroke, Mario’s parents Francesca Fedeli and Roberto D’Angelo, have been working with scientists and researchers to develop mirror neuron techniques in the hopes of creating even more ways for these children to thrive, develop and improve their outcome.

Research for pediatric stroke is historically under-supported and under-funded. This severely limits the ability to investigate important aspects, such as new treatments, factors influencing the quality of life, and causes and prevention of pediatric stroke. Alex, Mario and all children impacted by stroke depend on us working together to increase research and make critical improvements necessary to better understand, recognize, treat and someday prevent pediatric stroke.