Dr. Moran Huisman-Kedem explains the causes of strokes in children and how to identify them (Walla system)
It was another normal morning during which 4-year-old Ayala from Kalkiliye was getting ready for another day at the kindergarten near her house, when suddenly, without any prior warning, she fainted.
Her worried parents rushed her to the local medical center, which referred her to urgent care at the local hospital in Nablus.
At the hospital in Nablus, the doctors diagnosed that it was probably Ayala's leg syndrome.
Ayala was released to her home in good condition for further investigation, but suddenly her condition began to deteriorate again.
Her father, Muhammad recounts the critical minutes, "We didn't know what was causing the rapid deterioration in her condition and suddenly her entire right side became silent."
"We returned to the doctor in Qalqilya who referred us to imaging tests at the government hospital in Ramallah. There the doctors diagnosed a cancerous tumor in the head. Her condition continued to deteriorate and she began a process of kidney failure. I decided to transfer her to another Israeli hospital, where a dangerous cerebral hemorrhage was detected."
Dr. Yaakov Amsalem ,
a senior neuroradiologist and director of the interventional neuroradiology unit, experienced in treating the most complex cases in children and very small babies, who treated Ayala, says that for a whole year until she arrived at an Israeli hospital, Ayala suffered from a severe cerebral hemorrhage in the left hemisphere and repeated episodes of stroke.
An Israeli patient was diagnosed with a cerebral aneurysm and a partial closure of the aneurysm was performed using coils and a very dense metallic stent. This stent requires the administration of a blood thinner, so that blood clots do not form. Because it is a very small artery with a thickness of one and a half millimeters, despite the treatment, repeated cerebral events continued Until the situation where the girl stopped talking and started to be silent on the right side of her body.
Stroke in children is a very rare phenomenon.
Ayala and Dr. Amsalem after her recovery. (Photo: Shaare Tzedek)
"After a comprehensive assessment, we discovered that the stent was almost completely blocked together with the aneurysm that did not close all the way. This means a stoppage of blood supply to the left hemisphere of the brain which is responsible for the right side which is responsible for speech and understanding, a dangerous situation that could lead to a very severe disability and a real danger to her life. We were faced with two options , performing a bypass, a treatment involving many risks or a complex cerebral catheterization that requires a great deal of experience with tiny arteries such as Ayla that could have ruptured. After consultation and discussions, it was decided to perform a complex cerebral catheterization, in which a special balloon and material to close the aneurysm were used, which were successfully performed without side effects. The bleeding stopped Absolutely and to our delight, within a few hours Ayala's condition began to improve. In cooperation with the hematologists, we made an exact adjustment to the dosage of the medication suitable for the patient's weight and age."
This is what Dr. Amsalem says and emphasizes. A few days later Ayla was released to her home in good condition and returned to full activity
"A stroke in children is a very rare phenomenon, a recurrent stroke is an even rarer phenomenon. This is a rare case, with an incidence of one in half a million children. We are happy that we avoided irreversible damage. Caring for children requires special attention and adaptation to the tiny arteries while taking into account future growth of the various organs. We centralize the care of most children in Israel," they said at the hospital.
"We didn't expect something like this to happen to Ayala. She is a normally healthy girl who likes to run and play. After almost a year during which we almost lost her, at Shaare Zedek they saved our Ayala who returned to kindergarten and functioned normally like the other children. We want to thank the doctors and the nursing team and especially Dr. Amsalem Ayala's father concluded.