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October 2014; 4 (5) Clinical and Ethical Challenges

Diagnosis and acute management of perinatal arterial ischemic stroke

Jennifer Armstrong-Wells, Donna M. Ferriero
First published September 17, 2014, DOI: https://doi.org/10.1212/CPJ.0000000000000077
Jennifer Armstrong-Wells
Departments of Pediatrics (Neurology) and OB/GYN (JA-W), University of Colorado School of Medicine, Aurora; and the University of California San Francisco Benioff Children's Hospital and Departments of Pediatrics and Neurology (DMF), University of California San Francisco.
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Donna M. Ferriero
Departments of Pediatrics (Neurology) and OB/GYN (JA-W), University of Colorado School of Medicine, Aurora; and the University of California San Francisco Benioff Children's Hospital and Departments of Pediatrics and Neurology (DMF), University of California San Francisco.
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Diagnosis and acute management of perinatal arterial ischemic stroke
Jennifer Armstrong-Wells, Donna M. Ferriero
Neurol Clin Pract Oct 2014, 4 (5) 378-385; DOI: 10.1212/CPJ.0000000000000077

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Summary

Perinatal arterial ischemic stroke (PAIS) can be an unrecognized cause of short- and long-term neurologic disability. Focal clonic seizure in the newborn period is the most common clinical presentation of PAIS. MRI is optimal in diagnosing PAIS; negative cranial ultrasound or CT does not rule out PAIS. Given the low rate of recurrence in combination with risk factors thought to be isolated to the maternal-fetal unit, anticoagulation or antiplatelet treatment is usually not recommended. The majority of newborns with PAIS do not go on to develop epilepsy, although further research is warranted in this area. Long-term morbidity, including motor, cognitive, and behavioral disabilities, can follow PAIS, necessitating early recognition, diagnosis, and therapy initiation.

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  • Funding information and disclosures are provided at the end of the article. Full disclosure form information provided by the authors is available with the full text of this article at Neurology.org/cp.

  • © 2014 American Academy of Neurology
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