stroke in children

[mommabear70]

Hi there.. I know you can't doagnose this... but here is my story.. my son who was only 7 lst yer might of had a small stroke.. when he was 3 months old he has a large VSD,repair a PDA ligatin and a smal PFO (which he still has with intermitten bi directional flow)  last year at the end of may he had numbessm which I thought maybe he has NF (I do and I get numbness) it was in his limbs or just a limb.. one day he complained of headache and his chest feeling "heavy" after about 1/2 hour I gave him motrin and a neb treatment.. 45 minutes later I went into the room where he was laying down (on the floor) he pulled himself out with his left arm and pulled him self up with a chair.. he turn and his left leg was shaky and right foot in the air... he I told him to come sit with mom and dad.. he fell over I caught him and told him to come on he said  CACACACA so I lifted him out... about 10 min  later he could start to talk some and said he was numb on his right side.... a few days later it hit me about stroke  he coudln't at the time have a MRI as he had a cardiac implant.... school started and he has regressed big time.. had a neuropsych eval done they are very concerned and feel he had a stroke...
my question is  now that his implant is out, and can have a MRI will a small stroke always show up on a MRI.. he did see a neurologist who wanted more information from the schook and these testing before ordering a MRI as my son has had many xrays, MRI and CT's due to his heart and lungs... I am very worried about him... his thought process has slowed down some too...to me I am 99% sure he had a small storke and am worried he may have another..those numbness episodes could have been a warning... 10 months later will it show on an MRI and do all smal stroeks show up on MRI's
Thank you
Michelle

[Christopher R Newey, DO]

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 can not tell you what the exact cause of the symptoms is. However I will try to provide you with some useful information.

Stroke is a structural injury to an organ. It can be ischemic (caused by blockage) or hemorrhagic (i.e., bleeding). Patients with cardiac abnormalities may be at higher risk of having a stroke. Strokes can cause many clinical findings including weakness, numbness, changes in cognition, etc, depending on the location of the stroke. An MRI of the brain is a very useful modality to identify strokes. If indeed there was a structural lesion (i.e., stroke), it should be seen on the MRI. However, MRIs are only so specific and sensitive for detecting strokes.

I agree your son should continue following up with the neurologist. Neuroimaging would be useful. Also, if able, neuropsychological testing may be of benefit.  

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

[mommabear70]

Thank you for your information.. last week he did have a neuro-psych  eval and they are very concerned as they feel it could be a small stroke or lack of O2 he had when he was 5 weeks old (had RSV with a O2 of 70) but they feel if it was due to lack of  O2 then he would have been having issues right a long.. they did say it was showing that it is a neurological issue... I really am concerned and feaer this was a small stroke and he will havea another.. Thank you again for your information....
Michelle

[mommabear70]

I would like to add, not sure if possible but after his heart srugery when he was 3 1/2 months old they think he had MRSA (no drainage so no culture could be done but they treateed it with vanco and rocph..) any way they put in a PIC C and when his PICC line was n he developed a blot clot, could it be possible that they didn't remove all of his clot and not it let go?
also what he used to complaijn that his head was tingling at times Prior to this incident in June, I have never heard any one describe it like this  and one last note ever since that incident that night in June he has had no more head aches, numbness or issues of walking and not talking...
Thank you so much... I guess my main question is do all Strokes show up on MRI's even after 10 months has gone by
Michelle, mom to Chris