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Joy Colangelo -> Re: Peidatric Strokes (November 19, 2001 5:38:00 AM)
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I don't have any articles but two patients in the past with stroke. One, a 7 year old girl hit on the forehead with a soccer ball during a game. A day later, she has an embolic stroke with severe right sided paralysis (flaccid), aphasia, slight dysphagia. Seems she overstretched the carotid, it scabbed, the scab lifted and she stroked. Could be though that she dissected. We rehabed her for weeks and had poor compliance with physical rehab as school re-entry was a priority. She is now 15 years old and we just completed CIMT with great success after a tendon transfer for wrist extension and another for thumb movement. Gait during CIMT is near normal and hand function now an assist to the left rather than just a stabilizer. Another 8 year old stroked after chemotherapy and we also did CIMT with nice results in the hand function. However, no compliance once home and nearly all gains were lost. Again, perhaps other priorities like keeping him alive as I believe the cancer recurred in his leg.
My 29 year old neice, certainly not a child, but young nonetheless, recently had a major stroke after a carotid dissection -- good literature on that subject in MedLine. She came to live with me and I rehab'ed her to the best of my abilities - an ironic dream come true for a therapist and had an excellent outcome -- one always wonders how much return could be gained if we were on the job every day for hours at a time, for months at a stretch -- well a lot can happen.
Sorry for the length without any science. But those are my anecdotes. Compliance with children is a huge factor and it is such a shame as you have the ultimate plasticity.
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Joy
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