THIS MONTH’S PROFESSIONALS

Dr. Nivedita Thakur

Dr. Nivedita Thakur

Pediatric Neurologist

Dr. Nivedita Thakur Dr. Nivedita Thakur earned her medical degree and completed a residency and two fellowships in adult and pediatric movement disorders and pediatric neurology at the University of Texas Health Science Center at Houston (UTHealth) Medical School. She served as chief resident in pediatric neurology at UTHealth and was elected to Phi Beta Kappa as an undergraduate in biology at the University of Chicago. A member of the Child Neurology Society and the American Academy of Neurology, Dr. Thakur serves as an assistant professor in the Department of Pediatrics at UT Health. Her clinical interests center on spasticity and movement disorders in patients from birth to 18 years old.

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This Month’s Questions & Answers

  • AHA/ASA Katie Bahn
    AHA/ASA Katie Bahn, SUPPORT NETWORK Member Asks
    Q.

    "Are heart disease and stroke related to each other? If my child has heart disease, could she have a stroke?"

    A.

    In adults, high blood pressure, irregular heartbeat, hardening of the arteries, and diabetes can play key roles in stroke. However, this is less common in children. Children can have cardiac issues like congenital heart defects or acquired heart disease that can increase the risk of strokes. It is important for families to discuss the underlying cardiac condition and the risk of stroke with their physician.

    Dr. Nivedita Thakure

  • AHAASAKatie
    AHAASAKatie, SUPPORT NETWORK Member Asks
    Q.

    "Do children have the same stroke symptoms as adults?"

    A.

    Strokes in children, especially infants and newborns, can present differently than in adults. The symptoms could be misdiagnosed with more common conditions that mimic a stroke like viral illness, migraines, or epilepsy.

    Newborn/Infants:
    -Change in mental status--Example: extreme sleepiness
    -Seizures
    -Using one side of the body more than the other

    Older Children/Teenagers:
    -Focal signs like weakness
    -Change in mental status
    -Headache
    -Vomiting
    -Seizure
    -Balance/coordination issues
    -Sudden difficulty with speaking or comprehension
    -Sudden vision problems

    Should your child experience these symptoms, call 9-1-1 immediately.

  • AHA/ASA Katie Bahn
    AHA/ASA Katie Bahn, SUPPORT NETWORK Member Asks
    Q.

    "My baby had a stroke in utero. What are the main developmental achievements that I should look for as he grows?"

    A.

    Monitoring development will be important, especially milestones that a baby should achieve by a certain age.

    Development can be impacted by areas damaged in the brain. Thus the location and extent of injury are important factors. Another important aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or an undamaged area in the same location can take over function. Therefore it is difficult to predict exactly how much difficulty a child will have in the future.

    It’s important to follow development closely and get them in therapy to help practice skills they may be struggling with. This will allow the brain to use the pattern of repetition to build pathways that may have been disturbed due to the injury.

    Thank you, Dr. Nivedita Thakur

  • AHA/ASA Katie Bahn
    AHA/ASA Katie Bahn, SUPPORT NETWORK Member Asks
    Q.

    "What Causes a Pediatric Strokes in children?"

    A.

    Strokes in children can be caused by a variety of factors:

    Cardiac: Examples--Congenital heart defects or Acquired heart disease
    Hematologic: Examples--Sickle cell disease or Clotting disorders
    Infection: Examples--Meningitis or Encephalitis
    Vascular: Examples--AVM malformation or Moyamoya
    Metabolic or Genetic: Examples--Marfan syndrome or MELAS (Mitochondrial encephalomyopathy, lactic acidosis, and stroke-like episodes)
    Trauma: Example--head and neck trauma

  • SUPPORT NETWORK Member Asks
    Q.

    "Hi all. My son had a stroke in utero or at birth... he presented with seizures during the first 36 hours of life which were controlled with phenobarbital. He's 7 months now and is doing as great as we could all hope for. Meeting his milestones and more and has no deficits or signs of stroke as of yet. We know that prognosis for this is extremely variable, which is why I'd like to hear if anyone has a similar case/ experience and what the outcome was (in regards to the area of the brain that was affected). His stroke was in his left frontal lobe, I'd say maybe 1/8th of his left side and a small part of white matter in the back of his right side... the neurologist said he is almost borderzone if that helps... I've looked at studies and patients classified as borderzone seemed to have good prognosis... but the studies are all over the map and I don't really know what to conclude at this point other than expect the worst but hope for the best. Any information from patients or parents of children with similar diagnosis would help tremendously."

    A.

    Thank you so much for this question. You are correct in the information you have received so far. There are 2 key aspects that we consider. The first is the location and extent of injury. The second aspect is brain plasticity. Brain plasticity can be seen in babies because the brain is developing and so different parts of the brain or undamaged area in the same location can take over function. Thus it is difficult to predict exactly how much difficulty a child will have in the future. Key aspect is following development closely and getting them in therapy to help practice skills they may be struggling with, so that the brain can use the pattern of repetition to build pathways that may have been disturbed due to the injury. I hope this helps you with what to expect in the future.

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