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Neurologic profiles of infants and children after perinatal stroke
D A Trauner1, C Chase, P Walker
1Department of Neurosciences, University of California, School of Medicine, La Jolla, San Diego.
Insights
Children with perinatal stroke often achieve normal motor and intellectual milestones. Despite potential hemiparesis and seizures, isolated perinatal strokes generally lead to good long-term outcomes.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Perinatal Medicine
Background:
- Perinatal stroke, a significant cause of childhood neurological deficits, affects approximately 1 in 2,300 live births.
- Understanding the long-term neurodevelopmental outcomes of unilateral cerebral infarcts acquired around birth is crucial for clinical management and parental counseling.
Purpose of the Study:
- To evaluate the neurodevelopmental outcomes in children with a single, unilateral cerebral infarct acquired pre- or perinatally.
- To identify potential risk factors and prognostic indicators for intellectual and motor development following perinatal stroke.
Main Methods:
- A cohort of 29 children with confirmed unilateral cerebral infarcts (perinatal onset) were prospectively followed for an average of 43 months.
- Assessment included developmental milestone acquisition, neurological examination (evaluating for hemiparesis), intelligence quotient (IQ) testing, and seizure monitoring.
Main Results:
- Children achieved motor milestones near the expected age, even with hemiparesis.
- IQ scores were within the normal range for children over 2 years old.
- Over half of the children experienced seizures during the follow-up period, highlighting a common comorbidity.
Conclusions:
- Isolated perinatal strokes do not consistently preclude normal intellectual and functional motor development.
- Hemiparesis and seizures are common but do not necessarily predict poor long-term cognitive or motor outcomes.
- This study supports a generally positive prognosis for children with isolated unilateral perinatal cerebral infarcts.
Abstract:
Twenty-nine children with a single, unilateral cerebral infarct acquired pre- or perinatally were examined subsequently for an average of 43 months. No consistent pre- or perinatal events were identified to explain the occurrence of the stroke. The children acquired motor milestones at nearly expected times, even in the presence of hemiparesis. In children older than 2 years of age, I.Q. scores all were within the normal range. More than one-half of the children experienced seizures at some time during the follow-up period. Good intellectual and functional motor outcome can be expected in children with isolated perinatal stroke.