Stroke in Adolescents

When Erica Singleton fell on the playground in the fourth grade and couldn’t get up, neither her teacher, the school nurse nor her mother thought much of it. Stroke was certainly not on their list of possibilities. But when she collapsed again two weeks later, her mother took her to the hospital where a clear-thinking doctor recognized her symptoms for what they were — a stroke. (See Erica’s full story in Profiles of Adolescent Survival)

Stroke in children (from birth to age 18) occurs infrequently, between 4.6 and 6.4 per 100,000 depending on the study. The most common cause of stroke in adolescents (age 10-14) is damage to a blood vessel, what doctors label arteriopathy. “Sometimes that can be caused by trauma, like a car accident, or trauma to the neck that injures one of the blood vessels going to the brain,” said Kristin Guilliams, assistant professor of Pediatric Neurology and Critical Care Medicine at Washington University in St. Louis.

Therapy Needs of Adolescent Survivors

Dr. Kristin Guilliams

Children’s brains are developing and may be more plastic than those of adults, so therapy is helpful — and as with adult survivors, more is better. Motivating them to do their therapy, however, may be a challenge.

“Children, particularly in the preteen, teenage population, struggle with just wanting to be normal,” Guilliams said. “They may not want to do their therapy or take their medicines because they don’t see other children doing those things, even though therapy helps them get better. That is a common challenge in this age group.”

As with adult survivors, it helps adolescent survivors to meet other children who are going through the same thing, such as a pediatric stroke support group, a therapy summer camp or a rehabilitation research trial. “That can help normalize their symptoms or give them motivation by seeing what another child a few steps ahead of them in therapy is able to do,” Guilliams said.

Back to School

Typically, adolescent survivors have to deal with the challenge of returning to school. The first challenge is having to catch up to their peers because they’ve likely missed classes due to hospitalization, recovery and rehabilitation. “Then there is often the additional challenge that the stroke may cause learning disabilities,” Guilliams said. “That could be difficulty with executive functioning (the cognitive skills that help us get things done) or simple attention. Or something like verbal or auditory processing that might be affected, so that the children may not learn in exactly the same way as before the stroke.”

She suggests that a neuropsychological or learning assessment can help identify the adolescent’s cognitive strengths and weaknesses, so their school curriculum can be adapted to their needs. “If we know that after a stroke a child does much better hearing information and has difficulty reading, then perhaps there could be an adaptation through an individualized education plan (or IEP) where they are read the information or lessons,” Guilliams said. “That way, it’s just the material they’re learning that provides the challenge rather than the manner in which the material is presented providing an additional challenge.”

Beyond learning, there can be other cognitive challenges such as attention and depression. “This hasn’t been formally documented in the teenage stroke or childhood stroke population, but there are several studies that indicate they have more emotional and social difficulties compared to their peers,” Guilliams said.

Of course, any parent of an adolescent deals with puberty, and stroke does not appear to complicate that. However, the growth spurts that are common in children at this age may present a bit of a challenge: “Kids with motor weakness might have a little more difficulty walking after a growth spurt,” Guilliams said, “but that usually clears up in a few weeks.”

Things that can help

Growing and supporting self-esteem in their kids can be tricky for all parents of adolescents, and this can be particularly challenging in the case of child survivors. Guilliams suggests that parents should be particularly vigilant about depression. If they see signs and symptoms, they should seek treatment right away, counseling or medication or both. “A pediatric neuropsychologist would be ideal, but they are rare,” Guilliams said. “A clinical psychologist or licensed counselor could also provide appropriate intervention. A pediatrician or psychiatrist would prescribe medication if needed.”

Learning difficulties should be addressed quickly. Guilliams suggests that the Internet and social media can be a valuable resource. Although it should be closely monitored because of the potential for cyber-bullying, it can also be used positively. “Social media can connect survivors to other kids like them and help them know they’re not the only child going through the problems and challenges they’re encountering,” Guilliams said. “That can be an enormous benefit — to see and connect with peers.

“I would also encourage parents to remember that children are enormously resilient,” she said. “They continually impress me with their motivation and perseverance. So parents can both inspire their kids and be inspired by them.”

Editor’s note: The American Stroke Association’s Support Network is an online support community that includes a section specifically for parents of children who’ve had a stroke.

See Also: Developing Resilience: A Mother's Perspective


This information is provided as a resource to our readers. The tips, products or resources listed have not been reviewed or endorsed by the American Stroke Association.

Edit ModuleShow Tags

Featured Kids

Expect the Unexpected

At age 9, I had a hemorrhagic stroke, a bleeding into brain tissue, and the result of a brain tumor. The tumor was growing into nerves surrounding the brain stem. A blood vessel had ruptured, and the time frame between onset of stroke and onset of treatment was closing fast.

Kaysee Hyatt's Why

Kaysee Hyatt suspected something was wrong with her infant daughter, Addison. But it would be six months before it was confirmed Addison had had a stroke. After getting invaluable support via social media, Kaysee formed the nonprofit Pediatric Stroke Warriors to connect families in the Pacific Northwest.

Developing Resilience: A Mother's Perspective

“Your child has had a stroke.” Those words are hard to fathom — and just the beginning of a long road to recovery. It requires entire families to adjust to many challenges — and not just those faced by their child.

Profiles of Adolescent Survival

Shellby Watts and Erica Singleton both experienced strokes as children. Now 16 and 35 respectively, they reflect on their experiences and share how they’re doing today.

Keep a Good Spirit!

Her husband had a devastating stroke and, later, her 9-year-old daughter also had one due to a PFO (a hole in the heart), Eva has an important message for all stroke survivors and their families.

Stroke in Adolescents

Children’s brains are developing and may be more plastic than those of adults, so therapy is helpful — and as with adult survivors, more is better. Motivating them to do their therapy, however, may be a challenge.

A Mile in Her Own Shoes

I finished my first official mile in more than seven years. Seven years might be a long time without running a mile, but time didn’t matter to me. I was just happy to meet my goal. At 16, I had a hemorrhagic stroke from an AVM (arteriovenous malformation), leaving my left side weak.

Gracie Doran's Why

At the age of 10, Gracie Doran had a stroke due to cavernous hemangioma. But that hasn't kept her from doing what she loves. “Dance is my passion in life,” Gracie said.

A faster way to diagnose stroke in kids

An emergency room rapid response plan for children can help diagnose stroke symptoms quickly, a new study has found.

Parents Experience PTSD After Child's Stroke

Parents of children who have had a stroke can experience post-traumatic stress disorder (PTSD), and the children show signs of clinical anxiety.

Four Kansas City Teen Stroke Survivors Graduating Together in 2015

In the fall of 2011, Abby Anderson, Blake Ephraim, Madeline Mudd and Molly Ogden were among several thousand freshmen starting high school in the Kansas City area. Then came a traumatic series of events, all in a two-year span. Each suffered a massive stroke.

Tedy's Team Turns 10: A Stroke on the Ice

After homework, she didn’t watch TV or play video games, she practiced her stick handling in the driveway or cellar with a rubber ball and hockey stick. People began to refer to her as an "Olympic hopeful." All that changed when 12-year-old Jamie had a left-brain ischemic stroke on Aug. 9, 2009.
Edit ModuleShow Tags

Pediatric Resources

I am Jayden Foundation

I Am Jayden Foundation's mission is to spread awareness about pediatric stroke and become a source of funding for organizations/foundations/survivors who are associated with pediatric stroke. Funds go towards helping families or organizations who need financial assistance to better the lives of pediatric stroke survivors.

Sickle Cell Disease Association of America

The SCDAA's mission is to promote finding a universal cure for sickle cell disease while improving the quality of life for individuals and families where sickle cell-related conditions exist.

Share the Strokes Can Happen At Any Age infographic

Brendon's Smile

World Pediatric Stroke Association (formerly known as Brendon's Smile) provides opportunities to advocate and raise awareness among the general public locally and online.

Pediatric Stroke Program at the Children's Hospital of Philadelphia

The Pediatric Stroke Program at CHOP offers pediatric stroke awareness through their extensive family support program. They provide a multidisciplinary team approach in a hospital setting. The pediatric stroke program includes community outreach, meetings/conferences, assistance with the child’s education plan and quarterly newsletters.The hospital is located in Philadelphia, but anyone worldwide who is interested in their hospital services or getting involved in pediatric stroke activities is welcomed.

Bellaflies Foundation

The Bellaflies Foundation is a 501(c)3 non-profit foundation that is dedicated to “Making a Positive”. Their mission is to spread pediatric stroke awareness, support children's hospitals, and work to advance pediatric stroke research in medicine and testing worldwide.

Pediatric Stroke Warriors

We are dedicated in our mission of building community awareness for pediatric stroke and hope for impacted children and families throughout the Greater Pacific Northwest Region and beyond.

Colorado Pediatric Stroke: Parent Support Group

Offers local monthly support group meetings to provide support, education, and advocacy for families impacted by the range of outcomes of all types of pediatric strokes.

International Alliance for Pediatric Stroke (IAPS)

The International Alliance for Pediatric Stroke (IAPS) was created to unite pediatric stroke communities around the world. IAPS provides knowledge, hope, resources and the connection between families, medical specialists, researchers, healthcare providers and anyone affected by pediatric stroke. Our mission is proudly supported by leading pediatric neurologists and all of our information is approved by the physicians on our board.

Children's Hemiplegia and Stroke Association

The Children’s Hemiplegia and Stroke Association, CHASA, is a nonprofit organization founded by parents of children with hemiplegia in 1996 to provide information and support to families of children who have hemiplegia, hemiparesis, or hemiplegic cerebral palsy.
Edit ModuleShow Tags


Stroke Notes

Stroke-related news you can use about new scientific findings, public policy, programs and resources.

Readers Room

Articles, poems and art submitted by stroke survivors and their loved ones.

Life Is Why

Everyone has a reason to live a longer, healthier life. These stroke survivors, caregivers and others share their 'whys'. We'd love for you to share yours, too!

Everyday Survival

Practical tips and advice for day-to day living after stroke.

Life At The Curb

A unique perspective on survival by comedian and stroke survivor John Kawie.

Simple Cooking

Cooking at home can be a daunting task, but a rewarding one for your diet and lifestyle (and your wallet). Making small changes in your diet is important to your heart health. Here are simple, healthy and affordable recipes and cooking tips.

Helping Others Understand

Stroke affects people differently and many of the effects of stroke can be complicated. Helping friends and family understand how a stroke is affecting a survivor can help everyone involved.

Support Showcase

Our new department highlighting the good work being done by stroke support groups from around the nation. If you are part of a successful support group we should consider featuring, let us know!