Arterial Ischemic Stroke in Children

What is an arterial ischemic stroke?

An arterial ischemic stroke (AIS) is an injury to the brain or spinal cord caused by a lack of oxygen to the area affected. Usually AIS results from obstruction of blood flow by blood clots, narrowed or damaged arteries or both.

Children commonly recover from strokes more quickly and completely than adults, thanks to their young, healthy blood vessels and the ability of young brains to adapt following injury. Some strokes will have minimal or no long-term effect. Others, however, can cause problems, depending on the severity of the stroke, the part of the brain affected and how quickly it is treated. Complications can include weakness, sensory loss, visual difficulties and cognitive or language impairment.

What are the symptoms of an arterial ischemic stroke?

Symptoms of an arterial ischemic stroke typically start suddenly, and may affect just one side of the body. Newborns may show no noticeable symptoms, but some infants may have seizures or unusual irritability.

In older children, symptoms include:

  • seizures, especially affecting one side of the body
  • feeling weak or numb in the limbs, usually on one side the body or the face
  • trouble walking because of weakness
  • trouble speaking or understanding what others are saying
  • severe headache, especially one accompanied by sleepiness, double vision or vomiting
  • dizziness, loss of balance or falling
  • vision problems in one or both eyes

If your child has any of these symptoms, don't wait - go directly to an emergency room.

What causes an arterial ischemic stroke?

Children's arteries can become obstructed for a number of reasons, which fall in two main groups.

Blood clots caused by:

  • blood diseases, such as sickle cell anemia and clotting disorders
  • congenital heart disease, leading to clots that travel to the brain
  • serious infections
  • metabolic disorders
  • hypercoagulability, or abnormal blood clotting, around the time of birth (in newborns)

Damage to or abnormalities of the arteries, caused by:

  • accidents causing trauma to the head and neck
  • arterial dissection, a tear along the lining of an artery caused by trauma or medical conditions that weaken the artery's walls
  • moyamoya disease
  • cerebral arteritis or vasculitis

How we care for arterial ischemic stroke

Children who experience an arterial ischemic stroke should receive care from a multidisciplinary team of specialists, starting in the emergency room. At Boston Children's Hospital, our Stroke and Cerebrovascular Center team comes to the emergency department and quickly deliver clot-dissolving drugs to your child if appropriate. In some cases, we use tiny, catheter-based devices to break up or extract the clot physically. Our Cerebrovascular Surgery and Interventions Center has pioneered the use of these techniques in children. If the stroke was caused by injury or disease of the arteries themselves, we may be able to use a surgical or neurointerventional procedure to correct the condition. If the stroke is related to inflammation of the arteries in the brain, medical treatment to resolve vascular inflammation may be appropriate.

Once the immediate danger is past, our specialists provide long-term care, creating a comprehensive rehabilitation plan to help each child regain the best quality of life possible.