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Plasticity and Pediatric Stroke
By Pete Lewis
Every year, three of every 100,000 children have a stroke. Strokes among infants and children differ from adult strokes in several ways, but all strokes are caused when a blood vessel is either blocked or bursts. The result is that cells in the brain die.
When brain cells die, connections or pathways within the brain may be damaged. This may interrupt the normal flow of signals within the brain and between the brain and other parts of the body. Fortunately, our brains are very sophisticated and are constantly reorganizing and rerouting these connections. It's almost like taking a detour that will get you to the same place but using a different route. In some cases, a new pathway can be established or an unused connection can be reactivated, enabling signals to travel around the damaged area. This ability is called neuroplasticity.
Neuroplasticity is what enables us to learn. Every time we acquire a new skill or memory, pathways are established or changed inside our brains. We may say that a memory, fact or skill is stored in our brain, but it's more accurate to describe the brain as billions of ever-changing connections. Since we never stop learning, our brains never stop changing. However, as we age, the pathways within our brains become more committed and our ability to reorganize pathways decreases. Because children are still developing, their brains are far more plastic. While it stands to reason that this increased plasticity should benefit a child's recovery after a stroke, there is no scientific evidence to prove this assumption.
About 60 percent of young stroke survivors have some neurological deficit [something wrong with the way the brain works], said Dr. Mark Wainwright, a pediatric neurologist at Northwestern University Feinberg School of Medicine in Chicago.
“We used to think that children recovered from strokes better if they occurred during the first month of life,” Wainwright said. “We now know that problems related to the stroke [sometimes] don't manifest (present) themselves until later, usually when the child starts to develop speech.”
While a child may have some problems through life, Wainwright said, young stroke survivors tend to develop ways to “work around” or adapt to their stroke issues better than adults.
One important advantage young stroke survivors have is their general health. High blood pressure, diabetes, and high cholesterol are leading risk factors for strokes in adults.
“The good news for young stroke survivors is often what they don't have,” Wainwright said. “Brain recovery requires a good supply of blood, oxygen and energy. Since children generally don't have high blood pressure, diabetes or high cholesterol, their blood vessels often are healthy and their brains are functioning well.”
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