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(Stroke. 2007;38:742.)
© 2007 American Heart Association, Inc.

Cerebral Ischemia and the Developing Brain: Introduction

Perinatal Ischemic Stroke

Karin B. Nelson, MD

From the National Institute of Neurological Disorders and Stroke, Bethesda, Md.

Correspondence to Karin B. Nelson, MD, National Institute of Neurological Disorders and Stroke, NIH, Bldg 10, Room 5S221, Bethesda, MD 20892-1447. E-mail knelson{at}helix.nih.gov

Abstract

Perinatal ischemic stroke is not rare in term and near-term infants and is an important antecedent of long-term neurological disability, including congenital hemiplegia (hemiplegic cerebral palsy) and seizure and cognitive disorders. Changes in maternal hemostasis occur in pregnancy and are amplified in the period immediately surrounding birth; stroke and other thromboembolic events are more frequent in both mother and infant in this period. The vasculature and hemostatic mechanisms of placenta as well as brain are likely to be important in the pathobiology of perinatal stroke. Maternal and infant thrombophilias, genetic and acquired, play a role. Rarely is >1 child in a sibship affected, and environmental factors—substantially less studied, to date—are likely to be key determinants of risk.

Key Words: hemiplegic cerebral palsy • perinatal stroke

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