January 19, 2010

Stroke in Kids: It Does Happen

Stroke, an injury to the brain usually caused by a clot of blood that blocks delivery of oxygen to a portion of the brain, is thought of as an adults-only disease. It does happen in children, though, and it's worthwhile for parents to know about it, because the symptoms are frequently misdiagnosed. A father's account in the New York Times tells the story of his son Jared, who had a stroke at age seven. Now, two years later, his brain has mostly recovered, a testament to the remarkable power of children's brains to "rewire" themselves, especially when damage is limited to a discrete area. The most common signs of stroke in children or teenagers include the sudden appearance of:
  • Weakness of the face, arm or leg, usually on one side of the body
  • Trouble walking due to weakness or trouble moving one side of the body
  • Problems speaking or understanding language, including slurred speech, trouble trying to speak, inability to speak at all, or difficulty in understanding simple directions
  • Severe headache, especially with vomiting, sleepiness, or double vision
  • Trouble seeing clearly in one or both eyes
  • Severe dizziness or unsteadiness that may lead to losing balance or falling
  • New appearance of seizures, especially affecting one side of the body and followed by paralysis on the side of the seizure activity.
This list comes from Children's Hospital of Philadelphia (CHOP), which has the first pediatric stroke center in the country. In babies and newborns, the signs of stroke can be more subtle, but include seizures and extreme sleepiness, or unusual favoring of one side of the body. Parents who see sudden onset of these signs in their child should call 911 or get the child to an emergency room with expertise in stroke, and should consider a consult by telephone with the experts at CHOP. The stroke experts say that recognition of stroke is often delayed or even missed in most children. Many kids with stroke syndromes are misdiagnosed with more common conditions that mimic stroke, such as migraines, epilepsy or viral illnesses. But the key message is that early recognition and treatment during the first hours and days after a stroke is critical in optimizing long-term functional outcomes and minimizing the risk of a repeat stroke.

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May 2, 2008

Girl With Heart Disease Dies in Gym Class

Candi Martinez is filing a wrongful death suit against Las Cruces Public Schools because her daughter Destinie, who had heart disease, died after she was sent to gym class despite a note excusing her for medical reasons and then was kept from the hospital because the school called the wrong parents to obtain consent.

Destinie was kept in class even after she began vomiting.

This case (whatever its merits) reminds us of how the institutional nature of schools can lead to a child's individual medical problems going ignored by teachers and administrators, who may be too busy keeping general order to pay attention to an individual child.

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