Childhood strokes prove a riddle
They're more common than most people think, one reason they often go misdiagnosed for days.
One Wednesday in July 2006, Robin Roseman of Mount Laurel put her 18-month-old son, Ethan, to bed "a happy healthy kid." The next morning, he woke up vomiting and sleepy.
A Monday about three months later, Kevin Weaver, a 16-year-old cross-country runner at Pitman High School, returned home from a run, spent some time on the computer, and was about to go to bed about 10:30 p.m. when "out of nowhere, I got really dizzy. I was having a hard time walking straight," he recalled.
"My mom woke me up the next morning, and I was leaning to the right and slurring my speech."
Ethan and Weaver had suffered strokes. It would take Roseman three days to get the right diagnosis for her baby. In the meantime, he came close to dying.
It took Weaver's parents, Kelly MacDonald and Dave Weaver, eight days to find out what was really wrong with their son. He would be tested for drugs and alcohol, told he had a virus, and undergo a myriad of tests.
Stroke occurs in 25 of 100,000 newborns - the group at highest risk - and 12 of 100,000 children under 18, according to the Pediatric Stroke Program at Children's Hospital of Philadelphia. It is the sixth-leading cause of death in children. But strokes are so closely associated with adults, many children are often misdiagnosed with common conditions that mimic a stroke such as migraines or viral illnesses.
A child having a stroke "just doesn't come across our consciousness," said Rebecca Ichord, a physician and director of the Pediatric Stroke Program. The program treated about 180 children from the region between July 2006 and July 2007.
"As it turns out," she said, "most causes of adult stroke - diabetes, high blood pressure, hardening of the arteries - don't affect children.
"It's a tricky business" for the medical community.
And a nightmare for the children who suffer them and the parents who are frantic to find out what's going on.
Roseman, a dermatologist, took Ethan to Virtua Hospital in Voorhees the day after he had been vomiting. By then, he had stopped moving. She and her husband, Steve, were told Ethan was constipated.
"I kept saying over and over, 'It doesn't make sense; it doesn't make sense,' " she said. "Nobody really thought about the head. They kept saying, 'We'll see how he's doing in the morning.' "
Ethan wasn't doing well. His head lolled back whenever Roseman picked it up off her shoulder while she was holding him, which was pretty much all the time.
"In the morning I got on the phone with my dad, who is a radiologist," Roseman said. "I said, 'My son is dying.' He said, 'Do you think it's time to get him to CHOP?'"
Once there, Roseman said, "It went quickly." Tests were run. A clot was found in Ethan's sinus. Treatment was started.
Kevin Weaver's parents took him to Kennedy Hospital in Washington Township. He was slurring his words. "They saw there was a problem but didn't pick up on it," Dave Weaver said. Afterward, "We were in Denny's eating breakfast with a diagnosis of a virus."
It took several more days, several more doctors and several more tests - all to no avail - before an MRI revealed a clot, and MacDonald was referred to Ichord.
For both Ethan and Kevin Weaver, everything turned out fine, although "everytime I get lightheaded, I think it might be happening again," Weaver said.
Ethan spent a total of a month recovering at Children's Hospital of Philadelphia, learning how to walk again. Now he's a rambunctious boy who loves to play with his baby brother, 18-month-old Brandon. Weaver, now 17, started running again in about the same amount of time. He ran cross-country this season and was inducted into the National Honor Society.
Neither family is sure what caused the stroke. "To this day, we're left with a theory," Dave Weaver said. "But I think we're very fortunate the outcome is what it is."
Learn more about pediatric strokes, their causes and treatment at