Perinatal Strokes Cause Neurologic Disorders

Four of five newborn infants who experience a stroke around the time of birth will develop neurologic disorders, according to a new study published in the July 11, 2005, issue of the Annals of Neurology (Wily InterScience).

Researchers examined the medical records of more than 199,000 children born between the years 1997-2002. They found the overall rate of strokes during labor and delivery or in the month after birth to be about one in 5,000 live births. Since strokes must be confirmed by brain imaging, the authors note that the study likely missed some cases.

The most common disability, found in 58% of perinatal stroke survivors, was cerebral palsy. Other abnormal outcomes included epilepsy (39%), language delay (25%), and behavioral abnormalities, such as hyperactivity (22%). Cerebral palsy was more likely to occur in infants who had no symptoms early in life. In such cases, the stroke was typically discovered months after birth when the child was noted to have diminished use of one hand. These children were more likely to have sustained injury to deep structures of the brain that control movement. The authors did not find a single case of stroke recurrence, supporting the stance that these children should not be placed on prophylactic, anti-stroke medicines.

"Our data do not directly impact the current treatment of perinatal stroke,” said senior author Yvonne Wu, M.D., a child neurologist at the University of California, San Francisco (UCSF, USA). "However, we hope to raise awareness of this disorder. Infants with unexplained seizures or weakness on one side of the body should be evaluated by a neurologist, and should receive a head-imaging study to evaluate for perinatal stroke.”