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Childhood stroke is a rare but serious medical event, and recent evidence suggests that everyday illnesses might increase the risk of it occurring. A recent study published in Neurology indicates that children who experience an infection have a higher chance of suffering a stroke shortly afterward, while recent vaccinations show no such association. These findings highlight the importance of infection prevention to help protect the vascular health of young people.
Strokes happen when blood flow to the brain is blocked or when a blood vessel bursts. While strokes in adults are often tied to conditions like high blood pressure or high cholesterol, children who experience strokes usually do not have these standard risk factors. Instead, childhood strokes tend to stem from genetic diseases, heart defects, or blood clotting disorders.
Scientists are increasingly looking into the role of infections as a potential trigger for these events. Previous small scale studies pointed to a possible link between childhood stroke and common illnesses, like respiratory infections. However, comprehensive data tracking entire populations over several years has been lacking.
The researchers wanted to establish exactly how common childhood stroke is in a modern population. They also sought to determine whether recent infections or recent vaccinations play a direct role in triggering these medical emergencies. Some past reports hinted at a potential risk following certain childhood vaccines, but the scientific community needed to see if those findings held up when tested on a much larger scale.
“While stroke is typically considered a disease of the elderly, it can actually occur at any age, including in children. We were drawn to explore childhood stroke in this study to fill knowledge gaps in the disease epidemiology, including on stroke incidence, contemporary trends, and associated risk factors,” explained study author Lachlan Dalli, a postdoctoral research fellow at the School of Clinical Sciences at Monash University.
To conduct the study, the scientists analyzed health records from Victoria, Australia, covering the years 2017 to 2023. They looked at data for all residents aged twenty eight days to just under eighteen years old. This geographic area includes a population of roughly 1.4 million children.
The researchers used a secure system that links hospital admissions, emergency department visits, death registries, and national immunization records. This linked system allowed them to track severe medical events, recent illnesses, and vaccination histories for millions of young people over a long period.
Over the seven year period, the scientists identified 571 children who had experienced a stroke. About sixty percent of these events were ischemic strokes, which occur when a blood clot blocks blood flow to the brain. The remaining forty percent were hemorrhagic strokes, which happen when a weak blood vessel bursts and bleeds into the surrounding brain tissue.
To understand what might have caused these events, the scientists set up a matched comparison. They paired each stroke patient with up to five healthy control patients of the exact same age and sex. They ultimately matched the 571 cases of childhood stroke with a total of 2,734 control patients. These control patients had been admitted to the hospital during the same year for reasons entirely unrelated to a stroke.
The researchers also ensured the control group shared similar neighborhood wealth levels and pre existing medical conditions. This matching process helps to isolate the specific variables of interest, filtering out background differences in health and lifestyle.
The scientists then examined whether the children had recorded infections in the sixty days before their hospital admission. They looked for conditions like respiratory illnesses, stomach bugs, and more severe systemic infections. They also checked the national immunization register for any vaccinations administered in the forty two days prior, a timeframe commonly used in vaccine safety research.
The data showed that childhood stroke occurs at a rate of roughly 5.8 events per 100,000 children each year. The researchers noted that boys and infants under one year old had the highest rates of stroke among the studied population. Additionally, the scientists found that the overall rate of childhood strokes increased by forty two percent between 2017 and 2023.
The researchers suggest this increase might be due to better medical imaging and improved hospital coding practices over time. When looking at specific types of events, the rate for ischemic strokes was 3.7 events per 100,000 children. Meanwhile, hemorrhagic strokes occurred at a slightly lower rate of 2.1 events per 100,000 children.
Two out of every five children who had a stroke also had a documented infection in the two months leading up to the event. The most common illnesses reported were lower respiratory infections, upper respiratory infections, and widespread body infections known as sepsis. Other frequent illnesses included meningitis, which is a severe inflammation of the fluid and membranes surrounding the brain and spinal cord.
Upper respiratory viruses were particularly common among the children who experienced strokes. These included the coronavirus disease, respiratory syncytial virus, the influenza virus, and pneumococcal disease. Stomach bugs and urinary tract infections were also prevalent among the stroke patients.
When comparing the two matched groups, the scientists found that having a recent infection more than doubled a child’s odds of having a stroke. This elevated risk was strongest in the first two weeks following the onset of the illness. The association between infection and stroke was slightly higher for ischemic strokes than for hemorrhagic strokes.
Specifically, a recent infection increased the odds of an ischemic stroke by more than three times. The data suggests that the risk of an ischemic stroke remains elevated for up to six months after an infection. For hemorrhagic strokes, the elevated risk tends to fade after about two months.
“Our research shows that the risk of childhood stroke is not just immediate – it’s highest in the two weeks after an infection and stays elevated for up to six months,” Dalli told PsyPost. “This suggests that doctors and parents might need to think beyond the recovery period and watch for warning signs for stroke beyond the acute infection period.”
The scientists found no significant link between recent vaccinations and childhood stroke. Only about four percent of the stroke patients had received a vaccine in the weeks before their medical emergency. This vaccination rate was statistically similar to the rate seen in the healthy control group.
This finding provides reassurance regarding the safety of standard childhood immunization programs. It also highlights that the infections themselves pose a much greater risk to vascular health than the vaccines designed to prevent them.
While the study provides strong evidence linking infections to stroke, the scientists note several limitations. The reliance on hospital and government registry data means that mild infections treated at home were likely not counted. Because the data was anonymous, the scientists could not review individual medical charts to confirm exact diagnoses or the severity of the strokes.
This type of administrative record keeping could lead to some minor inaccuracies in how specific illnesses were classified. The scientists also point out that an observational study like this cannot entirely prove that the infections directly caused the strokes. It is possible that an abnormal immune system response or other unmeasured genetic factors contributed to the vascular issues.
Future research should investigate the specific biological mechanisms that might cause blood vessels to fail after an infection. Scientists also need to evaluate whether widespread vaccination programs might lower the long term incidence of childhood stroke. Preventing the very infections that tend to trigger these emergencies could be a viable strategy for protecting young patients.
The study, “Incidence of Childhood Stroke and Association With Recent Infection: A Population-Based Study Using Linked Data,” was authored by Lachlan L. Dalli, Muideen T. Olaiya, Hannah J. Morgan, Monique F. Kilkenny, Michael C. Fahey, Mark T. Mackay, Dominique A. Cadilhac, Tzu-Yung Kuo, Seana L. Gall, Hazel J. Clothier, Jacqueline A. Boyle, John Mallard, Daneeta Hennessy, and Jim Buttery.
