Presumed perinatal ischemic stroke: Vascular classification predicts outcomes

Abstract

Recognizable PPIS patterns predict long-term morbidity and may guide surveillance, therapy, and counseling. PVI is an underrecognized cause of PPIS and congenital hemiplegia.

Increased GABA-A Receptor Binding and Reduced Connectivity at the Motor Cortex in Children with Hemiplegic Cerebral Palsy: A Multimodal Investigation Using 18F-Fluoroflumazenil PET, Immunohistochemistry, and MR Imaging

“…The underlying etiology of congenital hemiplegia was proven to be perinatal ischemic stroke on conventional MR imaging, including venous infarction or small arterial infarction involved exclusively within the white mater as described previously (18). Patients with gray matter structural abnormalities such as cortical infarction, malformation, or any other type of congenital anomaly that may have influenced the cortical biodistribution of GABA-A receptors were excluded on the basis of visual assessment of conventional MR imaging (Fig.…”

“…Previously, Lee et al (12,13), using 18 F-fluoroflumazenil PET, demonstrated increased regional GABA-A receptor binding potential (BP) bilaterally in the motor areas of children with spastic diplegic CP who have bilateral periventricular leukomalacia. 18 Ffluoroflumazenil was recently introduced for central benzodiazepine receptor imaging (14,15).…”

“…18 Ffluoroflumazenil was recently introduced for central benzodiazepine receptor imaging (14,15). However, it remains to be elucidated whether GABA-A receptor binding is increased within the ipsilateral motor cortex of the affected hemisphere or contralateral hemisphere after perinatal brain injury.…”

Presumed perinatal ischemic stroke. A review

“…Periventricular venous infarction was the second most common cause of PPIS, and accounted for 22% of all cases, and for 75% when considering subcortical injuries only. 19 Given that PPIS is a perinatal stroke diagnosed at a later stage, the risk of recurrence is similar to that of perinatal stroke (less than 3%). Nevertheless, diagnostic approach should be supplemented with tests aimed at recognizing risk factors.…”

Preferencia manual precoz: signo de alarma de accidente cerebrovascular perinatal. Serie de casos

“…4 La edad de presentación y/o diagnóstico del PPIS va a depender del territorio cerebral afectado y, en consecuencia, de la secuela producida. 5 Debido a que las dos lesiones más frecuentes son los ACV de arteria cerebral media y los infartos venosos periventriculares (Figura 1), y ambas comprometen áreas motoras (ya sea corteza motora o tractos motores en la sustancia blanca), la mayoría de los niños con PPIS se diagnostican entre los 4 y los 8 meses de vida cuando comienza a hacerse manifiesta la hemiparesia congénita secuela del ACV. Sin embargo, algunos niños con lesiones que comprometen áreas motoras son diagnosticados luego del año de vida al iniciar la marcha.…”