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Perinatal Stroke

Mary Dunbar1, Adam Kirton2

  • 1Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada; Calgary Pediatric Stroke Program, University of Calgary, Calgary, AB, Canada.

Seminars in Pediatric Neurology
|December 10, 2019
PubMed

Insights

Perinatal strokes, affecting millions globally, are brain injuries in early development. This review details their types, causes, symptoms, and long-term effects like cerebral palsy.

Area of Science:

  • Neurology
  • Developmental Biology
  • Pediatrics

Background:

  • Perinatal strokes are focal cerebrovascular injuries occurring during early brain development.
  • These injuries impact an estimated 5 million individuals globally.
  • They represent a diverse yet specific group of neurological conditions.

Purpose of the Study:

  • To review the epidemiology, clinical presentations, pathophysiology, outcomes, and management of six subtypes of perinatal stroke.
  • To consolidate current knowledge on perinatal cerebrovascular injuries.
  • To highlight areas for future research in causation and outcome optimization.

Main Methods:

  • Systematic literature review.
  • Synthesis of epidemiological data.
  • Analysis of clinical presentations and outcomes across stroke subtypes.

Main Results:

  • Six subtypes of perinatal stroke are identified, categorized by symptom onset (neonatal vs. later in infancy/childhood).
  • Neonatal strokes often present with seizures (e.g., neonatal arterial ischemic stroke, neonatal hemorrhagic stroke, cerebral sinovenous thrombosis).
  • Later-presenting strokes typically manifest with motor asymmetry (e.g., arterial presumed perinatal ischemic stroke, presumed perinatal hemorrhagic stroke, in utero periventricular venous infarction).

Conclusions:

  • Perinatal strokes lead to significant long-term consequences including cerebral palsy, epilepsy, and cognitive/behavioral challenges.
  • The psychosocial impact on families is substantial.
  • Despite advances, further research is needed to understand causation and optimize recovery and management strategies.

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