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Acute cerebrovascular accidents (ACVA) are a group of syndromes that develop as a result of a sudden disturbance of blood circulation in the brain. They occur with sclerotic lesions of large and small vessels, heart disease, blood clotting disorders and other conditions.
ACVA is an acute cerebrovascular accident, or stroke: blood flow in an area of the brain is suddenly disrupted by a blocked or ruptured vessel, and brain cells begin to die. It is rare in children, but it requires emergency care, because the speed of that care affects how serious the consequences are.
In brief:
At CSM Clinic in Kyiv, the recovery period after an ACVA is managed by pediatric neurologists, while acute care is provided in a hospital.
Strokes and acute cerebrovascular accidents, which CSM doctors treat, are considered an age-related disease; according to statistics, they most often affect people over 65. But this does not mean that youth automatically rules out the risk. A person of any age can end up in the hospital with a stroke, even a teenager or an infant. The difference is only in the number of cases. For children, various sources give figures from 2-3 to 6-7 cases per 100,000 healthy children.
In Ukraine there are enough neurologists who are familiar with the clinical picture of stroke in adults and able to choose the right treatment and plan rehabilitation. But there are far fewer who have encountered ACVA in young children; even in Kyiv it is hard to find such a specialist. It is hard but possible: CSM specializes in neurology, and cerebrovascular accidents are among the conditions our specialists work with.
A cerebrovascular disturbance in children is a condition in which a certain area of the brain does not receive the nutrition it needs and its oxygen supply stops. As a result, some cells die, and some functions are lost along with them.
A stroke can be:
In children from birth to 18 years, hemorrhagic ACVA is diagnosed most often, but there are also cases of combined damage, when one lobe has hemorrhagic foci and another has ischemic ones. This is not the only classification of cerebrovascular disturbances. Depending on age, strokes are divided into:
Factors that increase the risk of circulatory disturbances in children under 18 include an abnormal course of pregnancy, persistently elevated blood pressure in the mother during pregnancy, traumatic birth, intrauterine infections, heart disease, and congenital anomalies of the blood vessels and cardiovascular system.
The exact causes of ACVA in children differ depending on the type of stroke. Hemorrhagic stroke can be caused by:
The set of causes of ischemic stroke is different and includes:
The combination of clinical manifestations remains the same for all types of lesions and includes the following symptoms:
The listed symptoms include manifestations typical both for children under one year and for older patients. When an ACVA occurs in children, they need emergency care: the sooner it is provided, the easier rehabilitation is, because the changes will be less deep and widespread.
However, a diagnosis of ACVA in a child cannot always be made the first time, because specific stroke symptoms such as one-sided loss of sensation and speech problems may be absent. In small children such changes are twice as hard to identify.
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Three periods are distinguished in the course of a stroke:
ACVA treatment protocols during the first two periods are aimed at maintaining normal blood pressure and body temperature, controlling intracranial pressure and preventing seizures. In the recovery period, the doctors' actions are aimed mainly at the child's rehabilitation and restoration of lost functions.
Treatment of ACVA in children in Kyiv at the recovery stage is one of the main services of CSM. Our methods are non-invasive and selective: micropolarization of the brain itself allows localized action, affecting only the damaged area of the organ and not the healthy areas. For the treatment of stroke in children, the clinic's specialists use the hardware methods available to them, some of which are rarely offered in Kyiv and Ukraine. Combined with classic rehabilitation approaches, this allows the Center's doctors to work with children whatever the complexity of the consequences and the prognosis.
A child's brain is more delicate and more plastic and responds to rehabilitation faster, so in some cases the consequences of the disease can be substantially reduced. The main thing is not to delay contacting CSM!
These are closely related concepts. ACVA is a broader medical term: it includes strokes (ischemic and hemorrhagic) and transient ischemic attacks, when symptoms quickly resolve. The word "stroke" is usually used for brain damage that has already been confirmed. In any case, these symptoms require urgent medical help.
Yes, although rarely: according to various sources, a few cases per 100,000 children. The risk is higher with congenital heart or vascular defects, blood diseases, diabetes mellitus and head injuries, and in newborns after complicated births. Therefore a child's symptoms should not be explained away by age or tiredness.
Call an ambulance (103) immediately and note the time the symptoms began. Until it arrives, lay the child on their side, loosen tight clothing, do not give food, water or medication, and do not try to lower blood pressure on your own. Do not wait until morning: help in the first hours is the most beneficial.
The main test is brain MRI or CT: they show the type of stroke and the size of the lesion. Additionally, ultrasound of the vessels of the head and neck, heart examinations and blood clotting tests are done. The acute period is examined in a hospital, and at the recovery stage a neurologist evaluates the results and, if needed, prescribes additional tests, including EEG.
Often yes, because a child's brain is more plastic and able to rebuild connections. The result depends on the type of stroke, the size and location of the lesion, how quickly help was provided and how early rehabilitation was started. Planned work (physical therapy, speech therapy sessions, hardware methods) may help restore lost skills.
Everything depends on the affected area. Most often these are weakness or stiffness of the arm and leg on one side, speech disorders, seizures, difficulties with attention, memory and learning, and vision problems. Some children develop a condition similar to cerebral palsy. Early rehabilitation may help reduce these consequences.
