This Article Full Text Full Text (PDF) All Versions of this Article: 34/12/2892    most recent 01.STR.0000106669.19525.0Fv1 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 Google Scholar Google Scholar Articles by Chabrier, S. Articles by Buchmüller, A. Search for Related Content PubMed PubMed Citation Articles by Chabrier, S. Articles by Buchmüller, A. Related Collections Stroke in Children and the Young

(Stroke. 2003;34:2892.)
© 2003 American Heart Association, Inc.

Original Contributions

Editorial Comment—Specificities of the Neonatal Stroke

Service de Pédiatrie et Groupe de Recherche sur la Thrombose, Centre Hospitalier Universitaire, Saint-Etienne Cedex, France

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

In this issue ofStroke, Kurnik and collaborators report the largest cohorts in the literature of children who presented with symptomatic arterial ischemic stroke in the neonatal period.¹ The study provides 2 major findings. First, it confirms, on a large scale, that many biological alterations are stroke risk factors in the neonatal period. Indeed, 127 out of the 215 neonates have a prothrombotic state. Even in the absence of a control group, the range of these disturbances (notably factor V Leiden mutation with an incidence of 15% and protein C deficiency with 4%) is clearly greater than in the general population. It is also higher than the rate of thrombophilia usually discovered in non-neonates with arterial ischemic stroke.² Although the prothrombotic condition is in general constitutional, the stroke rarely recurs. Only 4 of the 215 children had a second arterial ischemic stroke after a median follow-up of 3.5 years. Among them, 1 had congenital heart disease and 1 had congenital moyamoya disease, 2 conditions also at risk for recurrence of stroke in non-neonates. By comparison, studies concerning non-neonate children with arterial ischemic stroke reveal a rate of recurrence of 7% to 22% in the same span of follow-up.^3–5

These facts advocate envisaging some characteristics of the fetus or the newborn that predispose them to cerebral arterial ischemic events, especially in a context of thrombophilia. The first hypothesis is a lesion of cervicocephalic arteries during childbirth. Roessmann and Miller report the autopsy of a newborn who had a traumatic birth . . . [Full Text of this Article]