Tia's/ stroke

[bigbrother1998]

last year (MAY 2011)  my then 7 year old son had numbess in his extremeties one leg/both same as the arms.. then his event in June, unable to walk talk. started out with headache and "lungs felt heavy" 2 hours later he couldn't walk or talk (saying ca ca ca) his right foot was also up and turned in a little after I found him like that 15 minutes later he was able to talk and said his right side was numb.. it took me 10 months to convice the doctors to do a MRI on him, as I believed he had a stroke. (mean while when school started he could no longer spell words like WAS and FROM ) also on short term memory is affected and weakness on right side)  the docotrs said they think his stroke (left basil ganglia) was when he was 3 1/2 month old during his heart surgery according to MRI it looked like an older stroke.. I was told that TIAs (which I believe he was having for a month prior to this event can make a stroke show up older then it was is this true. also if his stroke was when he was a baby then why now all of a sudden would he start having issues after his big event last june, he is not the same little boy before this event and I hope he will regain spelling, strength and memory back but I am not sure if he ever will he will be 9 on the 21 of this month  Thank yoy Michelle

[bigbrother1998]

Thank you so much I really worry about him.  especially since they don't know what caused his stroke.  I also know that there isn't really anything we can do to prevent them, again thank you
Big brother

[CCF Neuro, M.D.]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with a doctor.

Without the ability to examine and obtain a history, I cannot tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

You mention that your son had a heart surgery at age 3 ½ months, and has evidence of an old stroke in the left basal ganglia. Babies born with heart problems (congenital heart defects) may be at an increased risk of having strokes before, during, or after surgery, for a variety of reasons. MRIs can show evidence of old brain injuries, such as strokes, but do not give an exact time/date that the injury occurred. The basal ganglia are structures located deep inside the brain that are important for controlling movement.  If your son had a stroke in the left basal ganglia then it could cause weakness and movement problems on the right side of the body as you described.

Transient ischemic attacks (TIAs) are brief episodes of stroke symptoms (weakness, numbness, difficulty speaking, etc) caused by blockages in the blood vessels of the brain which completely resolve on their own. The symptoms of a TIA will not last more than 24h, and unlike a stroke, do not cause brain tissue to die. TIAs can be a warning sign that someone is at an increased risk of a stroke.

I am unsure if the events you describe are truly TIAs, but I agree with you that they are concerning, and your son deserves to be evaluated by a neurologist. Children with a history of heart problems and old strokes are at risk for further neurologic problems, including developmental delays, intellectual disability, seizures, and weakness and movement problems. Further, children with heart problems may also be at increased risk for additional TIAs and strokes. The problems you describe may not be caused by new injuries, but may be manifestations of old injuries to the brain. A neurologist may wish to run further tests to better understand exactly what is going on now.  Also, if your son is followed by a cardiologist (heart doctor), he or she may need to run tests to make sure the heart is functioning normally as well.

Obtaining a timely appointment with a pediatric neurologist can be difficult. If it would be convenient for you to visit the Cleveland, OH area, you may call 866-588-2264 to inquire about an appointment with our Pediatric Neurology department.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided to be useful. Good luck.