Outcome Trajectories after Primary Perinatal Hemorrhagic Stroke

Area of Science:

• Neonatal Neurology
• Pediatric Stroke
• Neurodevelopmental Outcomes

Background:

• Perinatal hemorrhagic stroke in late preterm and term neonates is not well-studied.
• This study prospectively evaluates neurological outcomes at two months and two years post-stroke.

Purpose of the Study:

• To assess the neurological outcomes of neonates with perinatal hemorrhagic stroke.
• To identify long-term developmental trends in this population.

Main Methods:

• Enrolled neonates ≥36 weeks gestation with spontaneous hemorrhagic stroke (parenchymal/intraventricular) presenting within 28 days.
• Excluded hemorrhagic transformation of arterial ischemic stroke or cerebral sinovenous thrombosis.
• Assessed outcomes using the Pediatric Stroke Outcome Measure (PSOM) at two months and two years.

Main Results:

• Twenty-six neonates were included; 3 died during hospitalization.
• Among 22 survivors, 45% had no/non-impairing deficits and 30% had mild deficits at two years.
• Language subscores worsened significantly over time (P=0.009), while total PSOM scores did not change significantly (P=0.08).

Conclusions:

• Perinatal hemorrhagic stroke survivors generally show favorable outcomes in early childhood.
• A notable percentage experienced worsening language deficits, highlighting the need for close follow-up.
• Moderate to severe deficits were observed in only 5% of patients by age two years.