New Delhi : Stroke is considered rare among the paediatric age group, it is common in children below three. The possible reason for the low reported incidence is difficult diagnosis or missed diagnosis of the condition in young age group.  A unique reason for children suffering from stroke is trauma or injury caused by, say, a fall. Reported incidence of paediatric stroke ranges from 1.2 to 13 cases per 100,000 children under 18 years of age. Children usually recover better from strokes than adults do because the human body is still in developing stages. However, children can experience permanent complications from stroke, such as seizures, weakness, and vision problems.

According to World Health Organisation (WHO) stroke is caused by the interruption of blood supply to the brain. This usually occurs because a blood vessel bursts or is blocked by a clot, as this cuts off the supply of oxygen and nutrients, causing damage to the brain tissue. The two main types of stroke are ischemic (due to lack of blood flow) and hemorrhagic (due to bleeding). Both lead to impaired functioning of the affected area of the brain i.e a stroke.  

The first four hours, considered ‘golden’ for best treatment outcome, of suffering a stroke. As an example, we cite the story of Bhopal residents, Yasha Dave and Amit Dave who had a normal child, Purvasha Dave, with no history of distress before, during or after birth. However, they started noticing delayed milestones in Purvasha after the 3rd month along with recurring fever. They consulted many doctors and Purvasha underwent a battery of tests, however she was never diagnosed with any abnormality. At 11 months of age she suddenly fell down and suffered a stroke. She was diagnosed with cerebral infarct, which means that there was a clot in her brain that led to left sided paralysis. 

Although routine physiotherapy helped improve her muscle function; two months prior to her 2nd birthday, Purvasha sustained yet another fall from her bed and fell on her head. This time she was completely bed ridden and was hospitalized immediately. She has been on regular physiotherapy for 3 hours every day ever since. Some improvement was noticed in her overall condition, however, Purvasha failed to recover completely.

Initially grasping objects was possible only with her right hand, though her grasp was not strong. Mild intellectual disability was noticed. Slow learning and similar writing speed was observed. Muscle wasting was noticed in lower limbs making it difficult for her to stand as she would lose balance. Purvasha also found it difficult to sit for long periods of time.

PurvashaÂs parents searched on the internet for newer treatments and came across Dr. MahajanÂs work on neurological conditions. After consultation, they decided to go ahead with cell based therapy for Purvasha and she underwent 2 sessions over a period of 20 days. Purvasha is also under intensive rehabilitation programme comprising of physiotherapy and allied therapeutic modalities.

Post therapy Purvasha is now able to stand with support of splint without buckling of knees. Improvement in hand grasp is noticed. She is now able to speak 5-6 sentences clearly at a time and does not stammer much. Reduced spasticity and improved muscle strength is also noticed.

Cell based therapy has been shown to reduce the size of infarcts and improve functional outcomes in victims with cerebral infarcts. ÂNew treatment strategies focus on neurodegenerative approaches, among which the application of progenitor cells from bone marrow/adipose tissue has gained increasing attention. These cells have the capacity of self-renewal giving rise to differentiated cells from various lineages. Recovery after cellular therapy occurs through angiogenesis, neurogenesis, and synaptic plasticity, said Dr. Pradeep Mahajan, Regenerative medicine Researcher.