Because most people think of adults when they hear about stroke, children are often misdiagnosed, or their diagnosis is delayed. In fact, stroke affects 25 in 100,000 newborns and 12 in 100,000 children under 18 years of age.

Recognizing the signs and symptoms of stroke in children is vital to early and accurate diagnosis. According to recent research, children are far more likely than adults to report headache at the onset of ischemic stroke.

Lori Billinghurst, MD, a pediatric neurologist at Children’s Hospital of Philadelphia (CHOP), presented on this study at the American Stroke Association’s International Stroke Conference 2017.

“Stroke should be considered as a possible diagnosis in any child with a headache and additional symptoms of weakness or numbness (in the face, arm, or leg) or changes in walking, talking, or vision,” said Billinghurst. “Urgent brain imaging may be required to distinguish a migraine with aura from a stroke.”

The study included 355 children, ages one month to 18 years, who were enrolled in the multi–center Vascular Effects of Infection in Pediatric Stroke (VIPS) study, funded by the NIH. Researchers examined whether headache was reported at the time of the stroke.

Headaches were present in nearly half of all children older than 3. The number was considerably less in children under age 3 (6 percent), but researchers noted that younger children may not have been able to communicate if they were having a headache.

Study findings also indicated that headaches were most common in children with specific forms of blood vessel abnormalities.