in utero stroke?

[Willmum]

Has anyone had a lo suffer from this. My lo is 3.8 and has several difficulties. He is currently waiting for asd assessment, concerns have been raised re add/adhd and dcd/dsypraxia. He also has spd and speech disorder. From ed pych results he appears be of average abilty (just.

Anyway he also has horners syndrome (one pupil doesn't dilate properly) this was congenital. He also had a weakness down one side of his body (same side as horners). It was very noticable when he was a baby but the weakness difference is not noticable now.

I wonder when he was younger whether he may have suffered a stroke as he had many sympotoms, that seemed to fit, horners, tougue hanging to one side, thumb held inside hand on one side. Late with all milestones, dragging leaft leg when crawling/walking, unable to bring leaft arm to midline to meet left etc.

However, By the time we got referal to PT the difference was not really noticable and they just said he was fine. Also he did have an mri when he was little to check the horners wasn't being caused by a tumour (it wasn't thank god but no cause has ever been found).

I've mentioned it to one of two people but no-one seemed to take it seriously (maybe they just thought I was neurotic). Anyway fast forward to now. I have noticed that when he openes his mouh his uvula (the floppy soft bit that dangles at the back of the throat) is pulled right over to the side. It hard to tell if this is all the time or just when he opens his mouth as he wont let you look much, but it is very pronounced.

I quick bit of googling suggests again suggests a stroke as a possible cause. I really feel I need to pursue this but in all honesty don't know if I have the will to do so at the minute (currently in middle of a statutory assessment).

I'm unsure whether its worthwhile pursuing as I feel that
a- its may be unlikly this could be confirmed/denied
b- even if it is will it make any difference to what we are already doing with him, i.e OT, SALT. etc

I also feel that as he has had an mri when he was little then if anything was going to show up it would have done so then, or would the fact that they were looking for a tumour just mean that they would look for the tumour only?

If anyone has any experience of this I'd be grateful for your thoughts, I feel like I'm going round in circles.

Thanks

I don't have any experience I'm afraid but it does sound like you have genuine reasons for suspecting stroke. Even though it might not make any material difference, maybe you should ask that question and use the list you have made here. What/when is your next appointment? Maybe you need to see Paed to discuss. Otherwise, my first thought is to look for a child Stroke charity website for more info. Mind you, on MN there is bound to be someone who knows far more than I do so it is worth posting here and I'm sure you will get some better answers. I'm only up because the seagulls woke DD, grrrr.

Like Davros I know v. little (my only experience is of an elderly relative aving a haemorraghic stroke) but I agree with this does sound worth following up with the medics, I imagine it would need a neurology referral. From the little I know, I would imagine a CT scan is used more for diagnosis than MRI, I remember that my relative had a CT scan after the stroke.

An MRI should show a pre birth stroke, so if your DS had an MRI after most of the symptoms had resolved, it should still show some areas of damage, but a before and after is always a better bet as the brain will often work around damaged areas and look improved. They would not just look for tumours but for any abnormality, but they apparently did not find anything? An MRI is actually better at picking up brain damage than a CT thats why little ones are mainly MRId. There are plenty of kids with damage on the MRI who have developed normally, and children with normal MRIs showing developmental physical delays!!

Anyway, whatever the result of further scans it wouldnt alter the treatment or the symptoms, so is a bit pointless really. I understand about the 'knowing the cause' everyone wants an answer to the big 'why' question, but the thinking is 'treat the symptoms not the scans' so it may not be helpful to you.

By all means discuss with the paeds your feelings about strokes, never ever worry about being thought neurotic, you are a concerned parent, thats your right and you are perfectly normal to feel like that.

Unfortunately you often get from the professionals because they simply dont know and wont speculate, and unless there are valid reasons for further tests they wont do them.

Thanks for the replies. He did have mri that was normal, so I assumed there was either no damage to be seen or they didn't look for it. Feel better to know that they would have looked for any abnormalaties not just the tumour.

I guess I know it won't make any difference to the approach we take with him, I think I wanted to know that if this was the case, then could we draw any conclusions as to how it was likely to effect him in the future.

However, a bit more reading around suggests that results are really variable and its probably unlikly that we could draw firm conclusions anyway. It's comforting to know though that you can suffer with this and overcome it.

Thanks

My DD had a stroke in utero due to a placental abruption. We knew because she had seizures after she was born and an MRI confirmed there had been some damage. An MRI would pick up any damage so is a good sign that nothing showed up.

DD has mild motor difficulties and has been delayed with her milestones. I guess she has slight symptoms of someone who has had a stroke - difficulty with fine motor movement, balance and co-ordination.

Just to update I mentioned this to his paed and she now wants him to go for another mri scan to look at specifically at the brainstem area (apparently this is where the cranial nerves are).
Is there anyone who can advise whether this is likely to be worthwhile. Obviously the paed knows what she's talking about, I just cant help think that the first mri scan should have picked anything up so is probably a bit pointless?

The horners was present from birth but he did have whooping cough and was very ill with several episodes of low sats, following the orginal mri so I don't know if she maybe thinks that is significant.

Any advice?

Hello,

No real good advice, I'm sorry. But I'll give you my opinion ...

My son has hemiplegia - which is the same effect as a stroke. He has had it from birth, so a stroke either happened during the birth or during pregnancy. We never found out because sedation didn't work for the MRI and I didn't want to put him through it again (plus everyone on hemihelp (hemiplegia charity) seemed to find nothing much out from their children's MRI's - so I didn't think it was worth it).

My son had the same beginning delay symptoms as your son - but they never disappeared.

I have been told that MRI scans are more useful for the medical profession and research than for patients. But that's just hearsay ...

I've just accepted that what happened to my son is/was a mystery and knowing for me would not change anything.

But as I say this is not advice - its just opinion - and I might just be a bit odd!

My dd had an MRI at a week old following a stroke in utero. Showed damage but I have been told MRI's at this stage are not very helpful. Apparently after the age of 2 yrs they can tell you more about how the brain is developing.

I would be tempted to go for it so you have (hopefully) a definitive answer.