Strokes

A stroke occurs when blood flow to a portion of the brain is interrupted causing restricted blood flow. If blood flow is not restored, it will eventually lead to permanent brain injury. There are two broad classifications of stroke, ischaemic and haemorrhagic. 

Haemorrhagic stroke is caused by a break in the wall of a weakened blood vessel. Hypertension increases the risk in this cohort of patients.

Ischaemic stroke is caused by either blood clots or plaque occlusion of a blood vessel. They account for 85% of strokes 

In the case of an Ischaemic stroke, ECR may be possible. This involves threading a device through an artery, that can grab the clotted material and pull it out.
If that is not possible for whatever reason, or it does not work, IV thrombolysis may be possible. Thrombolysis is a medication that dissolves clots. 

Common symptoms include:

• Sudden loss of movement or weakness in part of the body, especially on one side (hemiparesis/ hemiplegia)

• Difficulty speaking (dysphasia)

• Difficulty swallowing (dysphagia)

• Visual disturbances

• Sudden onset of headache with neurological symptoms

Other conditions that mimic stroke must be considered:

• Tumors and Abscesses 

• Seizures and post-ictal states (Paralysis)

In infants the most common signs of stroke are seizures and extreme sleepiness. In toddlers to teenagers the clinical features are similar to adults. 

Additionally, the following features are commonly found in paediatric stroke patients:

• Dizziness, loss of balance, poor coordination

• Difficulty swallowing/drooling

• Seizures/weakness

• Difficulty concentrating

• Sudden collapse