Many folks are surprised to find out adults in their 20s, 30s, and 40s can have stroke. What’s often bigger news to people is that adolescents, children, newborns, and even fetuses can have a stroke. In fact, stroke in the womb is one of the leading causes of cerebral palsy.
Stroke in kids was nothing I had never even thought about before I started this journey to learn more about my own brain injury.
This week, I talk with one of the leading experts in childhood stroke. Strokecast regular, Dr. Nirav Shah, introduced me to Dr. Heather Fullerton. We had a fascinating conversation about stroke in children, the causes, and the generally optimistic recovery path.'Being born is a time period where you're at increased risk of having a stroke.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Dr. Heather Fullerton is a pediatric vascular neurologist at UCSF, one of only a few child neurologists in the country with additional board certification in vascular neurology. She is the Kenneth Rainin Chair in Pediatric Stroke Care, Chief of Child Neurology at UCSF Department of Neurology, and director of the Pediatric Stroke and Cerebrovascular Research Group and Pediatric Brain Center at UCSF Benioff Children’s Hospital.
After graduating from Baylor College of Medicine in 1996, Dr. Fullerton came to UCSF for her pediatrics residency and child neurology fellowship, and then joined the child neurology faculty in 2002. Early in her training, she cared for a 2-year-old girl who suffered a stroke caused by a tear in a neck artery from a fall. After realizing the paucity of research in this field–and lack of child neurologists with expertise in stroke–she chose to dedicate her career to the care of such children.
She completed a vascular neurology fellowship between 2002 and 2003, and a two-year master’s degree in clinical research at UCSF in 2005. She began doing clinical research in the field of childhood stroke, collaborating with renowned adult stroke researchers at UCSF. After starting a pediatric stroke clinic in 2002, she later established the multidisciplinary Pediatric Stroke and Cerebrovascular Center in 2006 and Pediatric Stroke and Cerebrovascular Research Group in 2009.'Mothers are hypercoagulable, meaning they form blood clots more easily, when they are giving birth…the baby also forms blood clots more easily ' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Dr. Fullerton’s research efforts have already improved the care of children with stroke.
She has performed novel work identifying which children with stroke are at risk for suffering a recurrence. This information not only guides physicians in determining which high-risk children need preventative treatment, but also provides enormous reassurance to families of children with low recurrence risk.
She led a groundbreaking study on risk factors for childhood stroke, determining that both minor acute infections and recent trauma are stroke and common risk factors.
She has also published work on pediatric arterial dissections, ethnic and gender disparities in childhood stroke risk, stroke rates in children with sickle cell disease, hemorrhagic stroke risk in children with arteriovenous malformations, and neurodevelopmental outcomes in children with vein of Galen malformations and PHACE syndrome.
She led an NIH-funded international study with 35-plus enrolling sites to better understand the association between childhood infections and ischemic stroke. She currently leads the part 2 of the said NIH-funded study to explore further analyses and test the overall hypothesis . She leads an AHA funded study on predicting stroke risk after minor trauma.'Those young infants are more likely to present with seizures. And if they don't have seizures, they just might present with excessive sleepiness.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
She also mentors junior investigators on a variety of other stroke related studies: stroke risk in childhood cancer survivors , stroke prevention in sickle cell disease, risk of epilepsy after stroke , the association between migraine and stroke in children, ADHD medications as a risk factor for stroke, and the role of atherosclerotic risk factors in stroke in children and young adults.
Tips for Living with a Child that Survived a Stroke'It's also fairly common in children for the neurologic symptoms of a stroke to wax and wane.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Dr. Fullerton offered these additional tips.
Don’t blame yourself. You will wrack your brain thinking of some way that you could have prevented your child’s stroke. You couldn’t. It was not your fault.
Enjoy your child for who they are, and know that their disability will make them a more empathetic person. A teenage survivor of a neonatal stroke once told me that if she could erase what had happened to her, and get rid of her disability, she wouldn’t. She knew it gave her a different lens for viewing others with disabilities, whether physical, intellectual, or social, and felt that made her a better person.'Whipping out that phone and taking some brief videos can actually be really important.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Hack of the Week
Using a phone one handed is certainly an option. As phones get bigger and we prefer to look at bigger screens, though, one handed uses is more challenging. You have reach further with your thumb to touch other parts of the screen or to tap out a text message, or really to use the functions you paid for.
And you have to do that without dropping it.
You can put the phone flat on a table, and that helps, but then the angle might be uncomfortable.
Instead, look for a dashboard or car window mount for your cell phone. You don’t have to use them in a car. Usually they have a suction cup mount or a beanbag mount that you can use to hold your phone where you want it on your desk, coffee table, or other surface.
Then you can tap away at any part of the screen since you don’t have to hold it in your hand.
'Vascular health is important and it starts at a young age.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Where do we go from here?
- What do think about the things Dr. Fullerton shared? Let us know in the comments below
- Be sure folks who you know who are involved with kids know that stroke can happen
- Share this episode by giving folks the link http://strokecast.com/pediatricstroke
Consider a car mount to hold your cell phone on your desk, night stand, table, etc.
- Don’t get best…get better
'You have a better recovery the more healthy brain you have that can take over the function of the injured brain. That's why we try so hard to prevent multiple strokes in children.' -- Dr. Fullerton, @UCSF #stroke #pediatric Click To Tweet
Strokecast is the stroke podcast where a Gen X stroke survivor explores rehab, recovery, the frontiers of neuroscience and one-handed banana peeling by helping stroke survivors, caregivers, medical providers and stroke industry affiliates connect and share their stories.