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Pediatric Strokes: What You Need to Know


Pediatric strokes, while rare, do occur, affecting one in every 1,100 newborns and an additional 2,000 older children each year. The cause of a stroke is either a blood clot or bleeding in the brain. If left untreated, it can lead to damage or death of brain tissue.

Whether a person suffering a stroke is an adult or a child, getting quick treatment from stroke specialists and the availability of recovery and reintegration resources can lead to better results.

Symptoms of stroke in children

Knowing what to look for and what to do if your child shows stroke symptoms is crucial to getting them life-saving care. The good news is that the signs and symptoms of stroke in children are similar to those of adults. Because of this, the FAST/BEFAST acronym applies to pediatric strokes as well.

BE FAST stands for the common symptoms of experiencing a stroke and what should be done:

  • Balance loss
  • Eyesight changes
  • Face drooping
  • Arm weakness
  • Speech difficulty
  • Time to call 911

If a child experiences a sudden seizure or headache, parents should call 911 or get them to an emergency room immediately, as time is of the essence in stroke care.

Working with specialists

When we suspect a stroke, our experts are called to the patient’s bedside within 30 minutes for rapid imaging, diagnosis, and initial treatment. If a stroke is confirmed, patients receive clot-busting medication right away. If additional treatment is needed to remove a clot, the medical team can walk the child next door to Barnes-Jewish Hospital.

Additional support

The St. Louis Children’s Hospital neuro rehab program provides additional support to help the child transition back into the home, school, and the community. St. Louis Children’s Hospital has the only pediatric inpatient rehabilitation program certified by the Commission on Accreditation of Rehabilitation Facilities in the St. Louis area.

Child life specialists help patients who need to remain in the hospital for rehab. They share ways to cope with fear, anxiety, and separation from friends and family by using play, music, art, recreation, and education techniques.

Our stroke and neurocritical care team follows patients after they leave the hospital. Suppose a child doesn’t meet the criteria for intensive inpatient rehab. In that case, we have a neurocritical care follow-up for kids with strokes to continue that support and integration back into school. This starts with their hospital discharge, where we learn more about their needs once they get back home. That transition and recovery are just as important as what we do in the hospital. This is the only place in the St. Louis region with complete comprehensive care.

A standard of extraordinary care

Parents should be aware of the symptoms of stroke, and not wait to call 911 if their children are experiencing any of the BEFAST symptoms. Even those who do not have a confirmed stroke may have another neurologic condition that needs attention.

The St. Louis Children’s Hospital team conducted over 100 stroke evaluations last year, with 18 final stroke diagnoses. The other times were often seizure-related or headache-related. They were almost always neurological issues.

Pediatric strokes can sound frightening. However, it is extremely rare for a child to die from a stroke, and many children will spontaneously regain lost function after stroke treatment. I remember treating a teenager with severe weakness and balance issues who quickly recovered after treatment. I saw them come back to themselves within only a few days. They didn’t even need rehab. You are a teenager, and you have no idea how your life trajectory may have changed if we hadn’t been able to treat your stroke. But that’s ok because I do.

BJC has hospitals throughout St. Louis and the surrounding region, which allows for speedy diagnosis and transfer to St. Louis Children’s Hospital for life-saving treatments. St. Louis Children’s also works with hospitals outside of BJC to share guidelines, education, and transfer protocols to help a child experiencing stroke symptoms get the extraordinary care they deserve as quickly and safely as possible.

You can learn more about St. Louis Children’s Hospital’s Stroke and Cerebrovascular Program here.

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