A Picture of a Stroke

Today we had a parent meeting with Ryder’s Neurologist.  We scheduled this appointment way back on March 26th when we got the news that our son had suffered a stroke in-utero.  It seemed like a really long wait to be able to get some questions answered, but in a way I think God might have delayed this appointment in order to spread some of the “heaviness” out and let us just enjoy Ryder and watch him develop for a while without someone telling us what he may or may not do.  Now we know that Ryder can walk, we hear him talking up a storm, we see him beginning to use his left hand, so all of these serious, scary questions that we would have had back then are completely pushed out of our minds as we watch our miracle baby defeat odds right before our eyes.  That still left us with a lot of questions, and I’ll share some of the answers we got:

What part of the brain did the stroke occur in and what does that section control?

Ryder’s stroke happened along the right lateral ventricle effecting the white matter, which is not the part that houses each of your functions.  Because of the location, it is not a function that will be affected, but instead it is the signals that the functions are sending to his left side asking it to react properly.  Since there are millions of little wires making all of these connections, it’s impossible to say exactly which ones have been damaged and which ones will make new pathways.

When did the stroke occur?  And why?

It is estimated that the stroke occurred somewhere between 24-30 weeks gestation because A) there is a cyst around the stroke location which would only happen in utero when the brain is still forming, otherwise it would be surrounded by scar tissue, and B) he was thriving when he was born and never went through an extremely “sickly” period, which would have happened if the stroke had occurred during or after birth.  There is no answer for why it happened.

Is Ryder at risk to have another stroke?  And what about any future babies that we might have?

NO and NO!  Shewww. 

Could his eyesight have been affected?  Sometimes we notice his right eye drifting while his left eye stays focused.

This is called Strabismus and it is actually common in many children, even those who aren’t stroke survivors.  It is best to wait and see if it corrects itself by age 2.  If not, follow up with a Developmental Ophthalmologist will be needed.  Your brain processes your eyesight directly behind your eye which is not near the stroke location, so it is not directly related to the stroke, but could have happened in some indirect way which wouldn’t show on the MRI.

So what is his diagnosis?  Sometimes we hear Hemiplegia, sometimes Hemiparesis, and sometimes (gasp!) Cerebral Palsy.

Cerebral Palsy is a term, not a diagnosis, referring to a motor development problem caused by damage to the central nervous system.  So by that definition the term cerebral palsy could be used to define the damage caused to Ryder’s brain that has left him with some motor impairments.  Hemiplegia is complete paralysis and Hemiparesis is partial paralysis or weakness, so his correct diagnosis is Left Hemiparesis.

Your outlook on the situation?

If someone were going to have a stroke, the best time to have it is in utero, the best place to have it is in the white matter, and the best chance to recover from it is as a child.  So everything is working in his favor but no one can say how much of a recovery he will make because the brain is an extremely complex thing…and everyone is different.  He most likely will not recover all of the sensation in his left arm, hand and fingers, and his left side will definitely be less coordinated…but whose isn’t?  This happens naturally as one hand dominates and the other becomes weaker.  As he gets older he might be able to tell you little quirks that are different for his left side than right, but most things he won’t notice because it will have been normal for things to feel that way his entire life.

So, before I show you a picture of Ryder’s stroke, is this not the most adorable brain you have ever seen?

Was that weird?  Okay sorry, I couldn’t help it, I think it’s cute!  Onto the real stuff, below is a picture of Ryder’s stroke.  The right side of the picture is normal, the left side shows the damage that was done.  It looks bad, but the Neurologist assured us that if it had spread and reached the outer part (the gray matter) it would have been devastating.

 

So there you have it, a picture of a stroke…but let me show you what a stroke looks like to us:

We look into these baby blue eyes and see a heart of gold, a determined spirit, and a child who has a genuine love for life.  He might keep his fist clenched, and he might end up walking with a limp, but whatever happens, he is a survivor.  And he is a true gift that could have only come from God above.