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(Stroke. 2009;40:1948.)
© 2009 American Heart Association, Inc.

Editorials

Neonatal Stroke Is Not a Harmless Condition

Ulrika Ådén, MD, PhD

From the Department of Woman and Child Health, Neonatology Unit, Karolinska Institutet, Stockholm, Sweden.

Correspondence to Ulrika Ådén, Associate Professor, Department of Woman and Child Health, Neonatology unit, Karolinska Institutet, Stockholm, SE17176 Sweden. E-mail ulrika.aden@ki.se

Key Words: stroke in children • stroke recovery

An extract of the first 250 words of the full text is provided, because this article has no abstract.

See related article, pages 2012–2019.

Neonatal arterial ischemic stroke, defined as a cerebrovascular event occurring between birth and 28 days postnatally with pathological or radiological evidence of focal arterial infarction, is now an increasingly recognized condition. The incidence is commonly referred to as 1/4000 live births,^1–4 but higher rates were recently reported.⁵ Because focal neurological signs of stroke are usually not evident in newborns, there are reasons to believe that the reported incidence of neonatal stroke in a given geographic region is strongly related to the use of neuroradiological techniques. There is now an emerging consensus that all infants with confirmed neonatal seizures should ideally undergo diagnostic neuroimaging to detect ischemic lesions. MRI is clearly the most sensitive technique.⁶

The etiology of neonatal stroke is not fully elucidated. In only half to three-quarters of cases^3,7 can a cause be identified. Major risk factors include prothrombotic disease, congenitial heart disease, and perinatal risk factors such as prolonged rupture of membranes and chorioamnionitis.^4,8,9 It is interesting to note that neonatal arterial ischemic stroke is related to abnormalities in the coagulation system rather than to fibrinogen activation, as commonly seen in adult stroke. Neonates seem to be at higher risk for stroke than older children,¹⁰ which may be because of the fact that pregnancy is a prothrombotic state with a surge of maternal coagulation activation.

Outcome studies to date demonstrate that neonatal stroke has a low mortality and that prognosis is more favorable than for older children and adults,^11,12 an effect attributed . . . [Full Text of this Article]

Related Article:

Late Emergence of Cognitive Deficits After Unilateral Neonatal Stroke

Robyn Westmacott, Daune MacGregor, Rand Askalan, and Gabrielle deVeber
Stroke 2009 40: 2012-2019. [Abstract] [Full Text] [PDF]