Identifying stroke early is essential for successful treatment

Popularly known as stroke, cerebrovascular accident (CVA) can happen at any age, and the approaching date, October 29, suggests awareness and greater understanding of the disease. Although not very common, the annual incidence rate of stroke in newborns and children ranges from 0.6 to 7.9 per 100,000 children.

This is what happened to the specialist in inclusion and diversity issues, Natalie Schonwald, who was born with a congenital defect known as tetralogy of Fallot, and had to undergo heart surgery when she was eight months old. And shortly after the procedure, doctors diagnosed a stroke with hemiplegia on the right side.

At a children’s stroke recovery center in London, Natalie underwent physiotherapy for two months and, according to her family, it was a very important process for both her and them, who learned to deal with the “new” and support her in its rehabilitation.

“Throughout my treatment, I did physical therapy, psychotherapy, occupational therapy and I had good doctors, for sure. Without a good team, I would not have been able to achieve satisfactory goals and be as well as I am today. Currently, I still have constant monitoring by a neurologist, cardiologist, neuropsychologist, I do swimming, physiotherapy and a personal trainer to strengthen and recover my movements”, explains Natalie.

Most of the time, childhood stroke occurs due to the influence of congenital or hereditary factors. During prenatal care, there is the possibility of diagnosing cardiac malformations during routine exams. At birth, the heel prick test is essential for screening for sickle cell anemia, an important risk factor for stroke in this population.

However, according to the neurologist at Hospital Israelita Albert Einstein and fellowship in Vascular Neurology at the Federal University of São Paulo (Unifesp), Dr. Isabella Mesquita Venâncio, the biggest challenge of stroke in childhood is its recognition, which is usually late, especially due to the lack of knowledge of their existence as children.

In addition to the often subtle symptoms, due to motor and speech skills not being fully developed, which can compromise the diagnosis and the stroke can only be recognized when the child already presents some sequelae and developmental delays. “Therefore, it is important to publicize this condition, which can be very serious and cause lifelong repercussions”, says Dr. Isabella.

World Stroke Day serves as a warning to parents, who need to be aware of some signs that their children may present, such as sudden weakness on one side of the body, crooked mouth, difficulty in articulating words, visual changes, headache intense and different from usual, and may be associated with vomiting and mental confusion. In the presence of any of these symptoms, it is recommended to seek medical help immediately so that an evaluation can be carried out by a specialized professional.

The doctor explains that some conditions mimic the symptoms of a stroke, such as migraines, epileptic seizures, Bell’s palsy and meningitis. However, due to the potential severity of the condition, it is essential that the child be evaluated by a neurologist. And that, for patients with known risk factors, more specific tests may be necessary.

“Those with heart disease, who must undergo cardiological evaluation on a routine basis, and children with sickle cell anemia, who must undergo transcranial Doppler at least once a year, in addition to regular follow-up with a hematologist and neurologist”, emphasizes Dr. Isabella.

The earlier the detection of neurological deficit and the diagnosis of stroke through imaging tests, such as tomography or magnetic resonance imaging, the faster therapeutic measures can be instituted, which aim to preserve brain tissue and reduce motor, cognitive and health complications. language that can be presented.

Muscle strengthening, dexterity and coordination training, improving speech and swallowing, cognitive development, as well as psychological support to face the period of hospital stay and rehabilitation are activities that aim to improve the child’s functionality.

“The rehabilitation period is a long and delicate moment, where we find the child in a greater state of vulnerability, with family support being crucial, which must be present in rehabilitation activities, providing support and learning techniques and exercises that can be also carried out at home, optimizing and increasing the chances of a complete recovery”, explains Dr. Isabella.