Childhood stroke is relatively rare, occurring in about two to three of every 100,000 children aged one to 14 per year. In comparison, stroke occurs in about 100 of every 100,000 adults per year. The rate of ischemic stroke and hemorrhagic stroke is similar among children aged one to 14.
Stroke occurs more frequently in children under age two, and peaks in the perinatal period. In the National Hospital Discharge Survey from 1980-1998, the rate of stroke for infants less than 30 days old (per 100,000 live births per year) was 26.4, with rates of 6.7 for hemorrhagic stroke and 17.8 for ischemic stroke.
More fatal strokes occur in African-American children than white children, mirroring the racial differences of stroke in adults. Compared to the stroke risk of white children, African-American children have an increased relative risk of 2.12, Hispanics a decreased relative risk of 0.76 and Asians have a similar risk. Boys have a 1.28-fold higher risk of stroke than girls and have a higher case-fatality rate for ischemic stroke than girls. The increased risk among African Americans is not explained by the presence of sickle cell disease, nor is the excess risk among boys explained by trauma.
Research conducted by the National Institute of Neurological Diseases and Stroke (NINDS) indicates a "stroke belt," or geographical area where fatal strokes are more predominant. This stroke belt includes Alabama, Arkansas, Georgia, Indiana, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Virginia. Researchers examined death certificates over a 19-year period and found a 21 percent higher risk of death from stroke in people under age 20 in the stroke belt states had compared with the same age group in other states. During the same period, people over age 25 in the stroke belt region had a 20 percent higher risk of death from stroke. Because the overall rate of stroke in children is low, researchers warn parents in these states not to be too alarmed. However, the findings indicate further investigation is needed.
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