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Mechanisms of perinatal arterial ischemic stroke

David Fernández-López1, Niranjana Natarajan2, Stephen Ashwal3

  • 1Department of Neurology, University of California San Francisco, San Francisco, California, USA.

Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism
|March 27, 2014
PubMed

Insights

Perinatal stroke causes significant long-term neurologic deficits. This review details the unique pathophysiology of neonatal brain injury and discusses emerging treatments for perinatal stroke.

Area of Science:

  • Neurology
  • Neonatal Medicine
  • Developmental Neuroscience

Background:

  • Perinatal stroke incidence is high, comparable to the elderly.
  • It leads to severe long-term neurologic and cognitive deficits, including cerebral palsy and epilepsy.
  • Neonatal brain damage pathophysiology is multifactorial and age-dependent.

Purpose of the Study:

  • To review fundamental clinical aspects of perinatal stroke.
  • To discuss recent findings on neonatal brain injury mechanisms.
  • To explore translational strategies and repair treatments for neonatal stroke.

Main Methods:

  • Review of emerging clinical data.
  • Analysis of experimental models of cerebral ischemia in neonatal rodents.
  • Synthesis of recent findings on cellular susceptibility, cell death, and blood-brain barrier responses.

Main Results:

  • The neonatal brain exhibits unique age-dependent responses to hypoxia-ischemia and focal arterial stroke.
  • Understanding of neuronal cell death dynamics, blood-brain barrier responses, and inflammation in neonatal stroke is advancing.
  • Long-term effects on angiogenesis and neurogenesis are being investigated.

Conclusions:

  • Perinatal stroke is a complex condition with unique neonatal pathophysiology.
  • Further research into cellular mechanisms and blood-brain barrier dynamics is crucial.
  • Translational strategies and therapeutic interventions are under development to improve outcomes.

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