Acute Perinatal Stroke Characteristics and Outcome in Southern Finland

Perinatal stroke can cause lifelong morbidities. Outcome prediction is important for parental guidance and follow-up. We studied characteristics of acute perinatal stroke in a Finnish cohort.

We performed a population-based study, identifying infants with acute neonatal cerebral ischemia or sinovenous thrombosis (CSVT) in Southern Finland from 2010 to 2023. We analysed the incidence of stroke types, seizures, anti-seizure medication use, and outcomes.

Altogether 88 infants (1 in 3101 live births) were diagnosed with acute perinatal stroke: 67% with arterial ischemic stroke (AIS), 22% with hemorrhagic stroke (HS) and 11% with CSVT. Seizures and anti-seizure medication use occurred in 78% of infants. Cranial ultrasound infrequently recognized AIS but usually noted haemorrhage. During follow-up, 34% of infants had no adverse outcome diagnosis. The most common outcome was cerebral palsy (CP, 35%). A combination of CP with epilepsy or seizures was more frequent in infants with AIS than in those with other stroke types.

The distribution of stroke types, symptoms, and adverse outcomes aligns with the previous literature. Acute seizures were common in AIS and HS patients. No recurrent strokes occurred during follow-up and underlying infant-related etiologies were rarely identified.