Child Stroke & Headaches

Lori L Billinghurst, MD, MSc pediatric neurologist at the Children’s Hospital in Philadelphia and Professor of Neurology at the University of Pennsylvania, identified from data that nearly half of all children aged over 3 years experienced a headache at the onset of their stroke. Pediatric stroke is, rare but unfortunatly not rare enough, it affects roughly 2 to 13 children per 100 per year but finding and diagnosing those children is much the same as finding a needle in a haystack.

While a headache was only present in 6% of patients younger than 3 years (5 out of 90), it was present in 46%  (108 out of 265) aged 3 years and over. Apparently, this is a higher rate than in adults with stroke according to a press release. However, I had a headache at the onset of my stroke and talking to stroke survivors I mentor this does not appear to be hugely uncommon, many having told me they also did. Fairly evenly weighted both ways, that is only my personal experience, however, not a reliable, factual study!

The main point highlighted here is that stroke really should be on the differential diagnosis for any child  with headaches and new onset symptoms; Billinghurst said, “They should really consider these children for rapid neuroimaging so that children who have stroke may be diagnosed and considered for hyper- acute therapies, for example, tissue plasminogen and mechanical thrombectomy.

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