As Chase Schweiger, then 7, was playing with friends, he collapsed. When mom Wendi Schweiger first saw him on the ground, she noticed his face looked odd. Hours later, they learned why: Chase had a “massive” stroke.
“Jordan and I were like, ‘What?! A stroke?’ We thought it was the strangest thing,” Wendi Schweiger, 48, of Marlton, New Jersey, told TODAY. “Sure enough, he had suffered a stroke.”
Fun with friends ends with an emergency
In May 2014, Chase and his friends were kicking a soccer ball near his house when, Wendi Schweiger, heard the boys urging Chase to wake up. At first, she thought her son was “fooling around.”
“I suddenly remember hearing one of the kids saying, “Chase get up,’” she recalled. “I saw Chase laying on the ground.”
She rushed over and noticed Chase’s face looked “strange" and that he couldn’t open his eyes and then he vomited. An ambulance rushed him to the hospital where it was suspected he had a seizure.
“I kept on saying to the doctor something seems strange about Chase’s face,” she said. “He wasn’t talking. He was kind of moaning and making these weird sounds and he was awake.”
Jordan Schweiger was out of town and when he arrived at the hospital, he spotted something different about his son.
“He noticed that Chase wasn’t moving his right side,” Wendi Schweiger said. “It is kind of ironic my husband who has no medical history is the one who noticed it.”
The local hospital transferred Chase to Children’s Hospital of Philadelphia (CHOP). Chase underwent scans to understand what had happened — he had experienced a stroke after two blood clots blocked blood flow to the left side of his brain. Testing did not indicate that there were any genetic reasons or injuries that caused it.
“(It damaged) the portions that control the speech and a lot of the motor skill on his right side,” Jordan Schweiger, 48, told TODAY. “They were starting to look at what else was happening to him.”
Jordan Schweiger asked Chase to give him a thumbs up if he could understand what they were saying and with his left thumb he showed that he did.
“He was communicating somewhat, but still that was it,” Jordan Schweiger said. “They noticed he seemed to be getting a little bit worse. The checked the swelling in his brain and it was starting to impinge upon the other side of his brain — to the point that it was going to start causing damage to the right side.”
To ease the pressure, doctors removed part of Chase’s skull.
“If he did not have that surgery, he would die,” Wendi Schweiger said.
While this increased Chase’s chances of surviving, the family felt unsure of what Chase’s future might look like.
“The comments at that point were, ‘He might just live this way.’ No speaking. He couldn’t keep his head up,” Jordan Schweiger said. “He might not walk again.”
Chase still used thumbs up and down to communicate but he couldn’t speak, eat or walk. Staff asked the family what the layout of the house was like because he need help navigating it. But then he started improving.
“Two days after surgery he actually said the word, ‘Yes,’” Wendi Schweiger said.
After 15 days in the ICU, he moved to the neurology floor before transferring to an inpatient rehabilitation facility. But he still didn’t have part of his skull.
“He had to wear a helmet. He was in a wheelchair. But they got him up and moving,” Wendi Schweiger said. “They do not give up at CHOP … They were incredible.”
Signs and symptoms of pediatric stroke
Pediatric stroke is both rare and more common than people know.
“Most people do not think it happens at all. And so it doesn’t enter people’s minds when they see a child who presents with having paresis,” Dr. Daniel Licht, professor of neurology at Perelman School of Medicine at the University of Pennsylvania and Chase’s doctor, told TODAY. “It is rare.”
But that also means that it’s tougher for doctors to research it.
“In adults, disease is common and in pediatrics disease is rare and we can’t study disease in children in the way we study disease in adults. We don’t have 100,000 patients with heart disease,” Licht said. “Even in a center like CHOP we have collected data in 150 kids with stroke but it took us 10 years.”
Stroke occurs in children for some of the same reasons it does in adults. Some children have clotting disorders, meaning they’re more likely to develop clots. Others experience an injury to the arteries in the neck that cause a clot to travel to the brain what’s also known as “dissection.” In Chase’s case, his stroke was “cryptogenic.”
“We don’t know why it happened,” Licht said.
Signs of stroke remain the same regardless of age and they spell out F-A-S-T.
- Facial drooping.
- Arm weakness.
- Speech problems.
- Time to act.
Sometimes people struggle to see symptoms in children because of their development. A toddler might not have enough language development, for example, for a parent to see a speech problems. Or people don’t even consider stroke can happen in children.
“You should be able to pick up on a motor problem and movement problem,” Licht said. “What tends to happen … is medical providers will say, ‘Oh maybe this was just a temporary thing.’”
When children are diagnosed with stroke right away an interventional radiologist will perform a procedure to remove a clot, a thrombectomy.
“That seems tremendously successful,” Licht said. “So we do that when a child presents with stroke symptoms in a time window of less than four hours.”
Recovery often involves other areas of the brain compensating for the damaged part.
“In Chase’s case, he had a language deficit when he came in,” Licht said. “He was able to recover language and it’s likely that language in now in a different part of his brain.”
His success is linked to his determination.
“Every child’s capacity to compensate for brain injury, in general, especially stroke, seems to be closely tied to the child’s motivation, to the family’s motivation and to rehabilitation services,” he said.
Recovery from pediatric stroke
From 8 a.m. to 4 p.m. for three months, Chase participated in therapy, including physical, occupational and speech.
“I remember the teacher coming to me and saying, he’ll never write again because he was a righty,” Wendi Schweiger said. “The next day he started writing with his left hand.”
Chase loved sports, both playing and watching them. As he recovered, he hoped that he could still play baseball. He kept pushing himself, even with setbacks, such as when they put his skull back together and it became infected. They had to remove the bone and replace it with a synthetic bone.
“It was always like one step forward two steps back,” Wendi Schweiger said. “It was really truly a rollercoaster.”
But Chase was determined. He worked hard and walked out of treatment. He’s now 15 and still participates in various therapies, some traditional and some not.
Having strong support from family and friends helped the family navigate Chase’s hospitalization and recovery. Chase is now 15 and will be a camp counselor this summer. He wears a brace on his right ankle to help him walk and has some weakness still on his right side. But that doesn’t stop him. He enjoys going to the gym and working with a trainer as well as spending time with friends.
“Chase has a lot of friends who look out for him,” Wendi Schweiger said. “I think the thing that really saddens him, though, is he just can’t play sports because of the minimal usage of his right arm and his stability."
The family is raising awareness of pediatric stroke because it seems unknown, even to some health professionals. Soon after his stroke, Chase had a seizure and the EMTs thought that they were coming to help a 77-year-old, not a 7-year-old. They never thought of a child as a stroke survivor.
“It’s really become our mission to educate people that kids can have strokes too,” Wendi Schweiger said. “It’s much more common that people think.”