Stroke doesn’t discriminate. Contrary to common misconceptions a stroke can happen to anyone at any age at any time. Whilst it is true that the risk and likelihood of stroke is higher in an older population, 1 in 4 strokes occur in younger or working age people (including children).

This World Stroke Day we highlight the impact of stroke on young people, the symptoms and warning signs to be aware of and consider why those signs may sometimes be overlooked.

What is a stroke? 

Stroke is the most common form of non-traumatic acquired brain injury and a leading cause of death world wide. 

A stroke occurs when the blood supply to part of the brain is blocked or cut off either by a bleed (haemorrhagic stroke) or by a blood clot (ischaemic stroke). The disruption in the blood supply also cuts off the supply of oxygen causing the cells in the brain to die (hypoxic brain damage). In the case of a bleed the flow of blood from the damaged blood vessel into other areas of the brain can also cause direct physical damage (from blood flow or pressure) to structures and cells in those areas of the brain.  

Know the Signs - Adults 

The initial symptoms of stroke will vary from person to person and will depend oin the area of the brain effected. However the main symptoms to watch out for are summarised using the acronym F.A.S.T.:

  • Face – has the face dropped on one side? Can the person smile? Has one side or their mouth or one eye drooped?
  • Arms – can the person lift both arms to the same extent? Do they feel weakness or numbness in one arm? 
  • Speech – is their speech slurred or garbled? Are they unable to talk despite appearing to be awake? Does what they are able to say make sense?  
  • Time – it's time to dial 999 immediately if you notice any of these signs or symptoms. 

Know the Signs - Children and Infants

Whilst the main symptoms of stroke in children mirror those in adults, children can also experience different symptoms to adults, such as seizures, headaches and fever. It is also important to be aware of the physical and visual signs that can occur in young children who are not old enough to effectively communicate the difficulties or symptoms they are experiencing. 

Strokes that occur in babies are rare, but when they do occur they will often present in the form of seizures and or extreme sleepiness. Parents may also notice that that the baby is favouring one side of the body or is having difficulty (or not) moving a particular limb. 

Warning signs of stroke in Children may include: 

  • limb weakness , particularly on one side, which may present as difficulty standing, walking or using the arm or leg, especially on one side.
  • excessive sleepiness.
  • dizziness. 
  • loss of balance or coordination. 
  • difficulty seeing or focussing with one or both eyes; parent's may notice that one eye is not tracking movement  in the same way as the other.
  • difficulty vocalising, talking, understanding, and or in older children reading and writing.
  • difficulty swallowing including (increased) dribbling or drooling 
  • severe or unusual headaches
  • nausea and or vomiting.
  • behavioural changes.
  • seizure(s) or collapse. 

If you are concerned that your child may be experiencing any of these symptoms then it is important to seek immediate medical attention.

Treatment 

Early diagnosis and treatment is key in terms of both of surviving the stroke itself and also ensuring the best outcome and prognosis for stroke survivors. If warnings signs are identified before an ischaemic stroke occurs then drug treatment can be preventative. Similarly if either a haemorrhagic or an ischaemic stroke is caught at a very early stage then treatment can be implemented to address the underlying clot or bleed and reduce the extent of any brain damage caused. The longer a stroke is left untreated the more substantial the damage is likely to be.  

Missed Opportunities? 

One of the factors that can lead to misdiagnosis or delays in diagnosis and treatment of a stroke can be the presumption that the patient is too young. As a solicitor specialising in stroke and acquired brain injury claims, I have successfully represented clients whose stroke symptoms were dismissed by neurologists as signs of stress and anxiety and also those whose treatment was delayed causing them to suffer further injury because the possibility of stroke was either not initially considered or was dismissed too readily by doctors without adequate investigations (such as diagnostic MRI or MRA scans).    

Campaigns such as FAST have been incredible effective in raising awareness of stroke symptoms in adults, but it is important that the people featured in these campaigns do not reinforce prevalent stereotypes regarding who might be affected. Raising awareness of stroke in younger people can help to ensure that warning signs are identified and treatment provided at the earliest stage when it can have the most benefit. 

Another way in which the opportunity for early or preventative treatment may be missed is if patients do not seek medical advice or are not identified as being at risk of stroke after experiencing milder or temporary symptoms as a result of Transient Ischaemic Attacks (TIAs). TIAs or 'mini strokes' occur when there is a sudden but temporary or transient disruption in the blood supply to the brain. the symptoms are similar to those of stroke (including speech and visual disturbance and or numbness or weakness in the face, arms and legs), but will resolve within 24 hours (often much sooner).  TIAs can indicate partial or temporary blockages in the blood supply due to smaller clots or developing obstructions. Therefore whilst TIAs can be sometimes be dismissed as a bit of a 'funny turn', they may be the first warning sign that someone is at risk of a more substantial stroke. Medical research shows that providing a bleed has been excluding implementing anticoagulant drug treatment can prevent that risk from materialising.  

Support for Younger Stroke Survivors 

Rehabilitation and support are key for all stroke survivors to help rebuild their lives and adapt to the impact of their injuries.  Whilst younger stroke survivors share many of the rehabilitation, therapy and medical needs of older stroke survivors, they can often have significantly different goals and expectations, particularly in terms of their return to employment, education or training, participation in activities, socialising, and the role they expect to play within their family. 

As a medical negligence solicitor I have the privilege of helping my clients to access the high quality rehabilitation, therapies and ongoing support to enable them to maximise their own recover and rebuild not only their own lives but those of their family and friends. However, for the majority of stroke patients who are not injured as a result of medical negligence, charities such as Different Strokes, which focuses on empowering and enabling working age and younger stroke survivors, and the Child Brain Injury Trust (CBIT)  provide invaluable sources of support and advice for younger stroke survivors and their families. For further information please see www.differentstrokes.co.uk or www.chiildbraininjurytrust.org.uk  

If you or a loved one have suffered a stroke and have reason to believe that the medical treatment you received may have been substandard then please contact Catherine Bell on 01865 781140 /Catherine.bell@freeths.co.uk or another of our specialist brain injury solicitors via https://www.freeths.co.uk/legal-services/individuals/clinical-negligence/acquired-brain-injury/  for advice.