scholarly journals Perinatal thrombosis: implications for mothers and neonates

Hematology ◽  
2015 ◽  
Vol 2015 (1) ◽  
pp. 48-52 ◽  
Author(s):  
Sarah H. O'Brien
Keyword(s):  
Ischemic Stroke ◽  
Treatment Strategies ◽  
Perinatal Period ◽  
Clinical Equipoise ◽  
Arterial Ischemic Stroke ◽  
Perinatal Stroke ◽  
Behavioral Challenges ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Abstract Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors. The importance of inherited thrombophilia in the pathophysiology and long-term outcomes of perinatal stroke requires additional study. At this time, there is no evidence to support routine extensive thrombophilia screening outside of a research setting. Despite the frequency of perinatal stroke and its association with substantial morbidity, treatment strategies are currently limited, and prevention strategies are nonexistent. Anticoagulation is rarely indicated in PAIS, and more work needs to focus on neuroprotective prevention and alternate treatment strategies. Anticoagulation does appear to be safe in CSVT and may prevent thrombus progression but clinical equipoise remains, and clinical trials are needed to obtain evidence regarding short- and long-term efficacy outcomes.

scholarly journals Perinatal Arterial Ischaemic Stroke In Neonate

2018 ◽  
Vol 08 (02) ◽  
pp. 123-125
Author(s):  
Anila Haroon ◽  
Shakeel Ahmed ◽  
Syed Rehan Ali
Keyword(s):  
Cerebral Palsy ◽  
Ischemic Stroke ◽  
Health Care Providers ◽  
Developing World ◽  
Perinatal Period ◽  
Care Providers ◽  
Arterial Ischemic Stroke ◽  
Perinatal Stroke ◽  
True Incidence ◽  
Hemiplegic Cerebral Palsy

Arterial ischemic stroke (AIS) is not uncommon in neonates, but in large part of developing world it has been missed and remains undiagnosed because of lack of resources and insufficient engagement by health care providers. The incidence of ischemic perinatal stroke ranges between 1 in 200 No, to 1 in 5000 births and is reported to be responsible for 30% to 50% of congenital hemiplegic cerebral palsy (CP) who were born at term or late preterm gestations. The true incidence of AIS from the developing world is not known as neuroimaging facilities are available in few centers; most of these cases remain undiagnosed. Over the past decades, ischemic perinatal stroke has emerged as an important cause of brain injury in the perinatal period and remains a leading cause of cerebral palsy. We are reporting a 3 days old male baby who presented with refractory seizures, subsequently diagnosed as arterial ischemic stroke

scholarly journals Pediatric Stroke: Clinical Findings and Radiological Approach

2011 ◽  
Vol 2011 ◽  
pp. 1-11 ◽  
Author(s):  
Giuseppe Lanni ◽  
Alessia Catalucci ◽  
Laura Conti ◽  
Alessandra Di Sibio ◽  
Amalia Paonessa ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Magnetic Resonance ◽  
Hemorrhagic Stroke ◽  
Clinical Findings ◽  
Pediatric Stroke ◽  
Arterial Ischemic Stroke ◽  
Venous Circulation ◽  
Cerebral Sinovenous Thrombosis ◽  
First Choice ◽  
Sinovenous Thrombosis

This paper focuses on radiological approach in pediatric stroke including both ischemic stroke (Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis) and hemorrhagic stroke. Etiopathology and main clinical findings are examined as well. Magnetic Resonance Imaging could be considered as the first-choice diagnostic exam, offering a complete diagnostic set of information both in the discrimination between ischemic/hemorrhagic stroke and in the identification of underlying causes. In addition, Magnetic Resonance vascular techniques supply further information about cerebral arterial and venous circulation. Computed Tomography, for its limits and radiation exposure, should be used only when Magnetic Resonance is not available and on unstable patients.

scholarly journals Impact of Thrombophilia on Risk of Arterial Ischemic Stroke or Cerebral Sinovenous Thrombosis in Neonates and Children

Circulation ◽  
2010 ◽  
Vol 121 (16) ◽  
pp. 1838-1847 ◽  
Author(s):  
Gili Kenet ◽  
Lisa K. Lütkhoff ◽  
Manuela Albisetti ◽  
Timothy Bernard ◽  
Mariana Bonduel ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Arterial Ischemic Stroke ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

scholarly journals B.3 The incidence of perinatal stroke is 1:1200 births in Southern Alberta: Population-based incidence of disease-specific perinatal stroke

2021 ◽  
Vol 48 (s3) ◽  
pp. S16-S16
Author(s):  
M Dunbar ◽  
J Hodge ◽  
A Floer ◽  
A Kirton
Keyword(s):  
Ischemic Stroke ◽  
Hemorrhagic Stroke ◽  
Case Series ◽  
Population Based ◽  
Arterial Ischemic Stroke ◽  
Stroke Incidence ◽  
Perinatal Stroke ◽  
Cerebral Sinovenous Thrombosis ◽  
Southern Alberta ◽  
Disease Specific

Background: Perinatal stroke encompasses six cerebrovascular syndromes which occur between the 20th week of gestation and the 28th post-natal day. Subtypes are neonatal arterial ischemic stroke (NAIS), neonatal cerebral sinovenous thrombosis (CSVT), neonatal hemorrhagic stroke (NHS), arterial presumed perinatal ischemic stroke (APPIS), periventricular venous infarction (PVI), and presumed perinatal hemorrhagic stroke (PPHS). Inconsistent terminology and lack of population-based case series has limited accurate measurement of disease-specific perinatal stroke incidence. Our objective was to define the incidence of the subtypes of perinatal stroke using a population-based cohort. Methods: The Alberta Perinatal Stroke Project is a research cohort established in 2008 in Southern Alberta. Case acquisition included retrospective hospital and ICD code searches (1990-2008) and prospective enrollment from all NICU and neurology/stroke clinics (2008-2017). Results: The overall incidence of perinatal stroke in Southern Alberta was 9.0 cases per 10,000 births, or 1:1200 births. Per 10,000 births, the incidence of each subtype was: NAIS = 3.2 (~1:3000), APPIS =1.2 (~1:8500), PVI = 1.5 (~1:6500), CSVT = 1.0 (~1:9900), NHS = 1.4 (~1/7300), PPHS = 0.1 (1/82,000). Conclusions: The overall incidence of perinatal stroke in Southern Alberta is 1:1200 live births. Population-based sampling of disease-specific states may explain why this rate is much higher than previous estimates

scholarly journals Clinical diversity of cerebral sinovenous thrombosis and arterial ischemic stroke in the neonate: a surveillance study.

2020 ◽  
Author(s):  
Anna-Lisa Sorg ◽  
Mathias Klemme ◽  
Rüdiger von Kries ◽  
Ursula Felderhoff-Müser ◽  
Andreas W. Flemmer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ischemic Stroke ◽  
Clinical Symptoms ◽  
Age At Onset ◽  
Arterial Ischemic Stroke ◽  
Generalized Seizures ◽  
Cerebral Sinovenous Thrombosis ◽  
Cerebral Mri ◽  
Incidence Risk ◽  
Sinovenous Thrombosis

Abstract Background Incidence, risk factors, clinical presentation, onset of symptoms and age at diagnosis differ between arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT) in the neonate. Distinguishing these two entities early and clinically can be of eminent importance. Methods Active surveillance for AIS and CSVT was performed in 345 German pediatric hospitals. Reported cases were validated with questionnaires. Only cases confirmed by cerebral MRI were included in our analysis. Both groups of patients (AIS and CSVT) were compared with regard to age at diagnose, pattern of clinical symptoms and risk factors. Results Data on 144 AIS and 51 CSVT neonatal cases were collected from 2015 to 2017. The relative risk of AIS was 2.8 [95% CI 2.1; 3.9] times higher compared to CSVT. CSVT patients were more likely to be born premature (CSVT 14/48, 29.2%; AIS 19/140, 13.2%; p = 0.02), to have signs of perinatal acidosis (e.g. umbilical artery pH ≤ 7.1 30.2% CSVT vs. 13.5% AIS p = 0.01). Generalized seizures and lethargy were more likely to occur in infants with CSVT (p < 0.0001). Age at onset of symptoms and at time of diagnoses was shifted to older ages in CSVT (p < 0.0001). Conclusion The risk for AIS is about three times higher than for CSVT in neonates. A higher proportion of critically ill infants in CSVT and a later onset of symptoms may indicate that perinatal and postnatal risk factors are more important for CSVT than for AIS. The data point to the need for awareness of CSVT in critical ill infants.

Neonatal Arterial Ischemic Stroke and Cerebral Sinovenous Thrombosis Are More Commonly Diagnosed in Boys

2004 ◽  
Vol 19 (7) ◽  
pp. 493-497 ◽  
Author(s):  
Meredith R. Golomb ◽  
Paul T. Dick ◽  
Daune L. MacGregor ◽  
Rosalind Curtis ◽  
Marianne Sofronas ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Arterial Ischemic Stroke ◽  
Cerebral Sinovenous Thrombosis ◽  
Sinovenous Thrombosis

Neurocognitive outcome in a 6-year-old girl with a history of perinatal stroke

2011 ◽  
Vol 26 (S2) ◽  
pp. 1100-1100
Author(s):  
A. Matos-Pires ◽  
N. Cardoso-Pereira
Keyword(s):  
Working Memory ◽  
Ischemic Stroke ◽  
Verbal Learning ◽  
Arterial Ischemic Stroke ◽  
Intellectual Performance ◽  
Perinatal Stroke ◽  
Intellectual Outcome ◽  
History Of ◽  
Perinatal Arterial Ischemic Stroke

Perinatal Stroke involves an often poorly understood neurocognitive events affecting the fetus and the new born with a potential for serious intellectual outcome.Our aim is to present a case study on the issue of neurocognitive defects on domains such as intellectual performance, attention and vigilance, executive functioning, visual perception, speed of processing, verbal learning and memory, and working memory on a 6 year old girl with perinatal arterial ischemic stroke.

scholarly journals Head circumference trajectory in children with perinatal stroke

2021 ◽  
pp. 088307382199610
Author(s):  
Amanda Leong ◽  
Amalia Floer ◽  
Adam Kirton ◽  
Aleksandra Mineyko
Keyword(s):  
Ischemic Stroke ◽  
Head Circumference ◽  
Developmental Outcomes ◽  
Normal Growth ◽  
Fisher Exact Test ◽  
Arterial Ischemic Stroke ◽  
Neurodevelopmental Outcomes ◽  
Perinatal Stroke ◽  
Head Growth ◽  
Poor Outcome

Background: Perinatal stroke is a leading cause of hemiparetic cerebral palsy and lifelong disability. Neurodevelopmental outcomes are difficult to predict and markers of long-term poor outcome continue to be investigated. Deceleration in growth of head circumference has been associated with worse developmental outcomes in neonatal brain injury. We hypothesized that perinatal stroke would result in decreased rates of head growth during childhood that would be associated with worse developmental outcomes. Methods: Patients with magnetic resonance imaging (MRI)–confirmed neonatal arterial ischemic stroke and arterial presumed perinatal ischemic stroke were identified from a population-based research cohort (Alberta Perinatal Stroke Project). Demographics and occipital-frontal circumference data were collected from medical records. Head growth was compared to typically developing control charts using a 2-tailed t test. The Fisher exact test was used to examine associations between Pediatric Stroke Outcome Measures (PSOM) scores and occipital-frontal head circumference. Results: Three hundred fifteen occipital-frontal head circumference measurements were collected from 102 patients (48 female, 54 male), over a median of 3.2 years (standard deviation = 5.18, range = 0-18.3). After 3 months for female patients and 1 year for male patients, occipital-frontal head circumference deviated and remained below normal growth trajectories ( P < .05) with a large effect size (Cohen d >0.8). Poor outcome (PSOM ≥ 1) was associated with smaller occipital-frontal head circumference ( P < .05). Conclusion: Head growth deceleration is observed in children with perinatal arterial ischemic stroke and is associated with poor outcome. Head circumference may be a tool to alert clinicians to the potential of abnormal neurologic outcome.

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