A child may frequently be found hemiplegic in the morning following an unwitnessed nocturnal seizure. An intracranial mass, either neoplasm or abscess, may mimic a vascular lesion. Tumors may often hemorrhage into a necrotic area, with localized compression or invasion of intracranial vascular structures. Infection must be considered since multiple micro-infarcts are a common complication of bacterial meningitis. Complicated and basilar migraines may be accompanied by neurologic symptoms, with alternating hemiplegia attributed to basilar migraine in children.
Several conditions cause stroke in children.
Heart disease is the most common of these, responsible for one-third of all ischemic infarctions in children. Another common cause is hematologic disorders such as sickle cell disease which is associated with multiple infarcts. Coagulation disorders such as hemophilia and platelet disorders have an increased risk of intracranial hemorrhage and stroke. Homocystinuria, an uncommon autosomal recessive disorder, leads to an increased tendency for thrombosis as a result of endothelial damage from excessive homocystine, thus leading to platelet aggregation and thrombus formation. Etiology of Stoke in Children.