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Published on: November 20, 2015
Risk and Prognostic Factors in Perinatal Hemorrhagic Stroke
Hüseyin Çaksen1, Fatma Tuba Köseoğlu1, Ahmet Sami Güven1
1Department of Pediatrics, Division of Pediatric Neurology, Necmettin Erbakan University, Meram Medical Faculty, Meram, Konya, Turkey.
Insights
Perinatal hemorrhagic stroke (PHS) is more common in preterm infants. Term infants with PHS showed higher rates of mucosal bleeding and multiple lobe involvement, with significant morbidity and mortality observed in both groups.
Area of Science:
- Neonatology
- Pediatric Neurology
- Neuroscience
Background:
- Perinatal stroke involves early brain injury.
- Perinatal hemorrhagic stroke (PHS) presents unique challenges in neonates.
- Understanding risk factors in preterm versus term infants is crucial.
Purpose of the Study:
- To compare risk and prognostic factors in preterm and term infants with PHS.
- To identify demographic, maternal, and perinatal factors associated with PHS.
- To evaluate clinical, neuroimaging, and outcome differences between preterm and term PHS.
Main Methods:
- Retrospective analysis of 66 infants diagnosed with PHS.
- Evaluation of demographic, fetal, maternal, and perinatal variables.
- Assessment of neuroimaging findings, complications, and long-term sequelae.
Main Results:
- PHS occurred more frequently in preterm infants (66.7%).
- Term infants had higher rates of primiparity, mucosal bleeding, and multi-lobe involvement.
- Preterm infants experienced more respiratory insufficiency, sepsis, and prolonged hospitalization.
- Mortality was linked to small for gestational age and mucosal bleeding.
- High rates of cerebral palsy, epilepsy, and hydrocephalus were observed in survivors.
Conclusions:
- PHS is more prevalent in preterm infants.
- Distinct risk factors and clinical presentations exist for preterm and term PHS.
- PHS is associated with substantial morbidity and mortality, necessitating early intervention.
Background:
Perinatal stroke encompasses a heterogeneous group of focal neurological injuries early in brain development. In this study, we aimed to compare risk and prognostic factors in preterm and term infants with perinatal hemorrhagic stroke (PHS).
Patients And Methods:
The study includes 66 infants with PHS. The infants were evaluated for demographic characteristics, fetal and maternal risk factors, perinatal events, clinical and neuroimaging findings, complications, and sequales.
Results:
Of 66 infants with PHS, 44 (66.70%) were preterm and 22 (33.30%) were term infants. Primiparity, mucosal bleeding, and multiple lobes involvement were more common in term infants than preterm infants (P < 0.05); however, respiratory insufficiency, neonatal sepsis, perinatal asphyxia, respiratory distress syndrome, use of invasive mechanical ventilation, use of noninvasive mechanical ventilation, and prolonged hospitalization were more common in preterm infants than term infants (P < 0.05). Eight (12.12%) infants died during infancy period. Small for gestational age and mucosal bleeding were more common in infants who are dead than those alive (P < 0.05). Forty-two (63.63%) infants were followed. Cerebral palsy and/or epilepsy and/or hydrocephalus were diagnosed in 36 (85.72%) infants during follow-up.
Conclusion:
Our findings showed that PHS was much more common in preterm infants. Mucosal bleeding and multiple lobes involvement were more common in term infants. PHS has high morbidity and mortality rates. Small for gestational age and mucosal bleeding were more common in infants who are dead.
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