Obstetrical and neonatal characteristics vary with birthweight in a cohort of 100 term newborns with symptomatic arterial ischemic stroke

Antenatal Factors Associated With Perinatal Arterial Ischemic Stroke

“…The preponderance of boys (59%) in this cohort was also found in other recent studies: 62% in a French study 8 and 57% in an International study. 9 Golomb et al 9 found that boys with PAIS had a higher birth weight, and they hypothesized that a traumatic and complicated delivery could be a cause of PAIS.…”

“…This clinical picture seems to be characteristic of PAIS according to previous studies. 2,8 For instance, Chabrier et al 8 found seizures in 91% of PAIS (74% of focal seizures), hypotonia in 46%, and apnea in 7%. The diagnosis of PAIS in cases of hemiplegia was delayed in 25% of cases at a median age of 8 months.…”

“…This finding is in keeping with other studies with corresponding rates of 74% or 89%. 2,8 The retrospective nature of this study precluded precise information about the incidence of thrombophilia in symptomatic PAIS. Although the incidence of thrombophilic disorders (27%) was higher than the 0.02% to 5% observed in the global population without thrombosis, 13 3 of the abnormal results were obtained in the first week of life at a time when interpretation of results was uncertain.…”

Thrombophilia risk is not increased in children after perinatal stroke

“…Multiple moderately powered case-control studies of clinical variables associated with NAIS have failed to define consistent associations supportive of causation. [7][8][9][10] They have agreed, however, that multifactorial pathogenesis is likely often required and that thromboembolism is almost certainly the culprit in arterial perinatal stroke. Placental disease leading to fetal cerebral embolism is a leading candidate mechanism, supported by associations with placental disease, common bilateral lesions without cardiac abnormality, and virtually no recurrence risk (,1% to 2%).…”

“…The pathogenesis of such arterial perinatal strokes is poorly understood. Case-control studies are limited, [7][8][9][10] and a recent meta-analysis 11 has methodological issues. Prevailing theory suggests many arterial perinatal strokes are thromboembolic events, possibly arising from the placenta.…”