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Etiology and treatment of perinatal stroke; a role for prothrombotic coagulation factors?

M H Cnossen1, C H van Ommen, I M Appel

  • 1Department of Pediatric Hematology, Erasmus Medical Center/Sophia Children's Hospital, Rotterdam, The Netherlands. m.cnossen@erasmusmc.nl

Seminars in Fetal & Neonatal Medicine
|August 12, 2009
PubMed

Insights

Perinatal stroke detection is increasing. While prothrombotic factors are common, they likely play a minor role in perinatal stroke development.

Area of Science:

  • Neurology
  • Pediatrics
  • Hematology

Background:

  • Perinatal stroke detection is rising due to advanced imaging, increased neonatal survival, and heightened pediatrician awareness.
  • Pathogenesis is multifactorial, involving maternal/neonatal risks and prothrombotic coagulation factors.

Purpose of the Study:

  • To provide an overview of prothrombotic risk factors in neonatal arterial ischemic stroke and cerebral sinovenous thrombosis.
  • To evaluate the role of prothrombotic coagulation factors in perinatal stroke pathogenesis.

Main Methods:

  • Review of existing studies on prothrombotic risk factors in neonatal stroke.
  • Analysis of the prevalence and potential impact of coagulation factors.

Main Results:

  • Prothrombotic coagulation factors are identified in over half of perinatal stroke cases.
  • Despite their prevalence, these factors appear to play a minor role in the condition's development.

Conclusions:

  • Current therapeutic guidelines for perinatal stroke are largely based on expert opinion.
  • Recommendations include heparin for specific stroke types and antiplatelet/anticoagulant therapy for recurrent events.

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