Abstract
Background
Perinatal arterial ischemic stroke is as common as large vessel arterial ischemic
stroke in adults and leads to significant morbidity. Perinatal arterial ischemic stroke
is the most common identifiable cause of cerebral palsy and can lead to cognitive
and behavioral difficulties that are amortized over a lifetime.
Methods
The literature on perinatal arterial ischemic stroke was reviewed and analyzed.
Results
Risk factors for perinatal arterial ischemic stroke include those that are maternal,
neonatal, and placental. The most common clinical signs at presentation are seizures
and hemiparesis. Evaluation should begin with thorough history acquisition and physical
examination followed by magnetic resonance imaging of the brain, with consideration
of magnetic resonance angiography of the head and neck, echocardiogram, and thrombophilia
evaluation. Treatment beginning early to include physical, speech, and occupational
therapies including constraint-induced movement therapy and close cognitive and developmental
follow-up may be beneficial. Future treatments may include transcranial magnetic stimulation,
hypothermia, and erythropoietin.
Conclusions
Perinatal arterial ischemic stroke comprises a group of arterial ischemic injuries
that can occur in the prenatal, perinatal, and postnatal periods in term and preterm
infants with different types of perinatal arterial ischemic stroke having different
clinical presentations, risk factors, and long-term outcomes.
Keywords
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Article info
Publication history
Published online: August 14, 2014
Accepted:
July 25,
2014
Received:
December 5,
2013
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
