This Article Free upon publication Full Text Full Text (PDF) All Versions of this Article: 38/8/2234    most recent STROKEAHA.107.483743v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Laugesaar, R. Articles by Talvik, T. Search for Related Content PubMed PubMed Citation Articles by Laugesaar, R. Articles by Talvik, T. Related Collections Cerebrovascular disease/stroke Clinical Studies CT and MRI

(Stroke. 2007;38:2234.)
© 2007 American Heart Association, Inc.

Original Contributions

Acutely and Retrospectively Diagnosed Perinatal Stroke

A Population-Based Study

Rael Laugesaar, MD; Anneli Kolk, PhD; Tiiu Tomberg, PhD; Tuuli Metsvaht, MD; Mare Lintrop, MD; Heili Varendi, PhD Tiina Talvik, PhD

From the Children’s Clinic of Tartu University (R.L.); the Unit of Neurology (A.K., T.T.), and Neonatology (H.V.), Children’s Clinic of Tartu University Hospital; the Radiology Department of Tartu University Hospital (T.T., M.L.), the Children’s Intensive Care Department (T.M.), Anesthesiology and Intensive Care Clinic of Tartu University Hospital, Estonia.

Correspondence to Prof Tiina Talvik, Unit of Neurology, Children’s Clinic of Tartu University Hospital, Lunini 6, 51014 Tartu, Estonia. E-mail Tiina.Talvik{at}kliinikum.ee

Background and Purpose— There are not very many epidemiological studies on perinatal stroke, and many authors suggest that this may be an underdiagnosed condition. The aim of the study was to estimate the incidence of perinatal arterial ischemic and hemorrhagic stroke in Estonia, to study the first clinical signs and to identify possible differences in predisposing factors and outcome between acutely and retrospectively diagnosed cases of perinatal stroke.

Methods— A retro- and prospective study of acutely (within the first month) and retrospectively diagnosed ischemic and hemorrhagic cases of perinatal stroke was conducted in a children population born in the eastern and southern regions of Estonia during the years 1994 to 2003. Patients were identified from a pilot study, hospital records, and an inquiry of child neurologists and general practitioners. The diagnosis was confirmed in 38 (12 were diagnosed acutely and 26 retrospectively) cases by neuroradiology (MRI or CT).

Results— The incidence rate of perinatal stroke in Estonia is 63 per 100 000 live births. Main clinical findings in the neonatal period were seizures, abnormalities of muscular tone, and disturbed level of alertness. Previously identified risk factors occurred in 32% of cases. Children with early diagnosis had more often adverse events during pregnancy and delivery (P<0.05) and developed more severe stage of hemiparesis compared with children with late diagnosis (P<0.05).

Conclusions— The incidence rate of 63 per 100 000 live birth is higher than previously reported. Detailed analysis of the first signs of perinatal stroke may improve the early diagnostics of perinatal stroke.

Key Words: clinical signs • incidence • perinatal stroke

This article has been cited by other articles:

				J. G. Millichap Prevalence and Predictors of Perinatal Hemorrhagic Stroke AAP Grand Rounds, June 1, 2009; 21(6): 69 - 69. [Full Text] [PDF]

				U. Aden Neonatal Stroke Is Not a Harmless Condition Stroke, June 1, 2009; 40(6): 1948 - 1949. [Full Text] [PDF]

				J. Armstrong-Wells, S. C. Johnston, Y. W. Wu, S. Sidney, and H. J. Fullerton Prevalence and Predictors of Perinatal Hemorrhagic Stroke: Results From the Kaiser Pediatric Stroke Study Pediatrics, March 1, 2009; 123(3): 823 - 828. [Abstract] [Full Text] [PDF]

				S. G. Pavlakis and K. Levinson Arterial Ischemic Stroke: Common Risk Factors in Newborns and Children Stroke, March 1, 2009; 40(3_suppl_1): S79 - S81. [Full Text] [PDF]

				M. J. Simchen, G. Goldstein, A. Lubetsky, T. Strauss, E. Schiff, and G. Kenet Factor V Leiden and Antiphospholipid Antibodies in Either Mothers or Infants Increase the Risk for Perinatal Arterial Ischemic Stroke Stroke, January 1, 2009; 40(1): 65 - 70. [Abstract] [Full Text] [PDF]

				J Pappachan and F J Kirkham Cerebrovascular disease and stroke Arch. Dis. Child., October 1, 2008; 93(10): 890 - 898. [Abstract] [Full Text] [PDF]

				P. Temesvari Perinatal Stroke With No Obvious Cause Stroke, February 1, 2008; 39(2): e35 - e35. [Full Text] [PDF]

				T. Metsvaht, R. Laugesaar, A. Kolk, and T. Talvik Response to Letter by Temesvari Stroke, February 1, 2008; 39(2): e36 - e37. [Full Text] [PDF]