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Hemiplegic Cerebral Palsy: Clinical Features Associated With Arterial Ischemic Stroke or Periventricular Venous

Trish Domi1, Darcy Fehlings2, Pradeep Krishnan3

  • 1Neurosciences and Mental Health, Child Health Evaluative Sciences Program, The Stroke Imaging Lab for Children, Hospital for Sick Children Research Institute, Toronto, ON, Canada.

Journal of Child Neurology
|April 10, 2025
PubMed

Insights

Clinical features like neonatal seizures, systemic thrombosis, and emergency cesarean sections are linked to hemiplegic cerebral palsy caused by perinatal arterial ischemic stroke, differentiating it from periventricular venous infarction.

Area of Science:

  • Neurology
  • Pediatrics
  • Neonatology

Background:

  • Hemiplegic cerebral palsy (HCP) is a common childhood motor disability.
  • Perinatal brain injury is a leading cause of HCP.
  • Distinguishing between arterial ischemic stroke and venous infarction is crucial for understanding etiology.

Purpose of the Study:

  • To identify and compare clinical features of HCP associated with perinatal arterial ischemic stroke (PAIS) versus periventricular venous infarction (PVI).
  • To elucidate the distinct clinical presentations and risk factors for these two common forms of focal brain injury in HCP.

Main Methods:

  • A cohort study of 144 children with HCP across 9 rehabilitation centers in Ontario.
  • Comparison of children with PAIS versus PVI based on neuroimaging.
  • Analysis of prenatal and perinatal clinical data from birth records and parent interviews.

Main Results:

  • Neonatal systemic thrombosis, emergency cesarean section, and neonatal seizures were significantly more common in children with PAIS compared to PVI.
  • Preterm delivery rates were similar between the PAIS and PVI groups.
  • Specific clinical features were associated with PAIS, aiding in differentiating it from PVI in HCP.

Conclusions:

  • Emergency cesarean section, neonatal seizures, and systemic thrombosis are key clinical features distinguishing PAIS from PVI in children with HCP.
  • These findings enhance understanding of focal brain injury patterns contributing to HCP.
  • The study supports existing knowledge on the etiology of focal brain injury leading to HCP.

Keywords:
MRIcerebral palsymagnetic resonance imagingpediatricstroke

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