Stroke in children

Childhood stroke affects around five out of every 100,000 children a year in the UK. The term, ‘childhood stroke’, covers from the twenty-eighth week of pregnancy up to the age of eighteen.

The causes and the effects of a stroke are likely to be different depending on how old the child is.

A stroke happens when the blood supply to part of the brain is cut off.

There are two main types of stroke.

Ischaemic strokes are caused by a blockage in the blood supply to the brain. Haemorrhagic strokes occur when blood leaks from a burst blood vessel into the brain. In adults, 80 percent of strokes are caused by a blockage and 20 percent by a bleed in the brain. In children, both types of stroke are equally common.

Children can also have transient ischaemic attacks (TIAs).

A TIA happens when the brain’s blood supply is interrupted for a very brief time. The symptoms only last for a few minutes or hours and then completely disappear, usually within 24 hours.

Pediatric Stroke Symptoms include:

Difficulty talking
Neck pain or stiffness
Numbness or tingling
Onset of lethargy or difficulty walking
Seizure
Sudden collapse
Sudden loss of consciousness
Sudden loss of movement or weakness of face, arm or leg
Sudden onset of severe headache
Vomiting

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Varicose Veins

Varicose veins are swollen and enlarged veins that usually occur on the legs and feet. They may be blue or dark purple, and are often lumpy, bulging or twisted in appearance.

Other symptoms include:

  • aching, heavy and uncomfortable legs
  • swollen feet and ankles
  • burning or throbbing in your legs
  • muscle cramps in your legs, particularly at night
  • dry, itchy and thin skin over the affected vein

The symptoms are usually worse during warm weather or if you’ve been standing up for long periods of time. They may improve when you walk around or if you rest and raise your legs.

Varicose veins develop when the small valves inside the veins stop working properly.

In a healthy vein, blood flows smoothly to the heart. The blood is prevented from flowing backwards by a series of tiny valves that open and close to let blood through.

If the valves weaken or are damaged, the blood can flow backwards and collect in the vein, eventually causing it to be swollen and enlarged (varicose).

Certain things can increase your chances of developing varicose veins, such as:

  • being female
  • having a close family member with varicose veins
  • being older
  • being overweight
  • having a job that involves long periods of standing
  • being pregnant
  • other conditions

If treatment is necessary, your doctor may first recommend using compression stockings, taking regular exercise and elevating the affected area when resting.

If your varicose veins are still causing you pain or discomfort, or they cause complications, they can be treated in several ways.

The most common treatment options include:

  • endothermal ablation – where heat is used to seal affected veins
  • sclerotherapy – this uses special foam to close the veins
  • ligation and stripping – the affected veins are surgically removed

It’s unlikely you’ll receive treatment on the NHS for cosmetic reasons – you’ll have to pay for cosmetic treatment privately.

If you do feel you require treatment, it might help if you print out treatment options for varicose veins to discuss with the GP.

There’s little evidence to suggest you can stop varicose veins getting worse or completely stop new ones developing.

But there are ways to ease symptoms of existing varicose veins, such as:

  • avoiding standing or sitting still for long periods and trying to move around every 30 minutes
  • taking regular breaks throughout the day, raising the legs on pillows while resting to ease discomfort
  • exercising regularly – this can improve circulation and help maintain a healthy weight

Types of varicose veins

There are several types of varicose veins, such as:

  • trunk varicose veins – these are near to the surface of the skin and are thick and knobbly; they’re often long and can look unpleasant
  • reticular varicose veins – these are red and sometimes grouped close together in a network
  • telangiectasia varicose veins – also known as thread veins or spider veins, these are small clusters of blue or red veins that sometimes appear on your face or legs; they’re harmless and, unlike trunk varicose veins, do not bulge underneath the surface of the skin

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Blunt Chest Trauma

Any injury to the chest (damage to the area between the neck and the abdomen including the ribs) can cause impairment to breathing leading to hypoxia. Hypoxia is a pathological condition in which the body as a whole (generalised hypoxia), or a region off the body (tissue hypoxia) is deprived of adequate oxygen supply. An undiagnosed chest injury can cause one or both lungs to collapse causing pressure on the heart; and ultimately cardiac arrest.

 

The two types of chest injury are:

1. Closed:

The skin has not broken and air does not enter the chest cavity through the chest wall.

 

2. Open:

The chest wall has been penetrated by a foreign object.

 

Causes of Chest Injury:

  • Blunt Trauma.
  • Penetrating objects.
  • Compression (crush injury).

 

Examples of Chest Injury:

  • Fractures ribs.
  • Fail segment.
  • Pneumothorax (air entering the pleural cavity).
  • Open Pneumothorax (open sucking wound).
  • Haemothorax (blood entering the pleura cavity).
  • Tension Pneumothorax (air trapped in the pleura cavity under positive pressure displacing other organs).

 

NB: THE PLEURA CAVITY is the space between two pleura (serous membrane) visceral and parietal, which cover the lungs.

 

Signs & Symptoms:

  • Difficulty in breathing.
  • Uneven-unusual chest movement.
  • Panic and anxiety.
  • Pain at site of injury.
  • Blueness around the lips.
  • Pain.
  • Rapid heart beat.
  • Rapid breathing.
  • Poor oxygenation (SATS below 94%).

 

NB: SATS or Oxygen Saturation is a measure of how much oxygen the blood is carrying as a percentage of the maximum it could carry. A healthy individual would have SATS between 94 -100%.

 

Treatment:

  • Place casualty in the most comfortable position, if possible inclined to the injured side.
  • If open sucking chest wound, prevent air entry ASAP. If possible use a credit card, cling film or any air-tight seal to cover the wound. This must be taped on three sides to prevent air getting in, but will allow air to come out.
  • Dial 999.
  • If First Aiders are pulse Oximetery & Oxygen Therapy trained, then deliver oxygen therapy appropriately.

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