[Perinatal stroke - from symptoms to follow-up]

Area of Science:

• Neonatal neurology
• Pediatric stroke research

Background:

• Analyzed patient characteristics of term neonates diagnosed with stroke between 2006 and 2017.
• Focused on a 3rd level Neonatal Intensive Care Unit (NICU).

Purpose of the Study:

• To analyze patient characteristics of term neonates with stroke.
• To understand presentation, imaging, etiology, and clinical context.

Main Methods:

• Conducted a retrospective and prospective analysis of 18 newborns with stroke.
• Included follow-up at 2 years or later.
• Reviewed presentation, imaging (ultrasound, MRI), etiology, and clinical context.

Main Results:

• Incidence in the unit matched international databases (1 in 1600-4000 births).
• Head MRI is recommended over cranial ultrasound for arterial ischemic stroke detection.
• Common etiologies included thrombophilia, infection, vascular malformation, asphyxia, and pre-eclampsia.
• Middle cerebral artery (50%) and anterior cerebral artery (33%) were most affected.
• Early childhood developmental support led to average or above-average gross/fine motor and cognitive outcomes.
• In utero stroke cases showed severely impaired development.

Conclusions:

• Perinatal stroke should be considered in neonates with neurological symptoms in the first few days after birth.
• Early developmental support is crucial for achieving normal outcomes, even with extensive brain damage.
• In utero stroke is associated with severe developmental impairment.
• Inherited prothrombotic disorders may impact future pregnancies.