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Perinatal Strokes May Be More Common Than Thought

Predisposing factors and outcomes differ between acutely and retrospectively diagnosed cases

MONDAY, Aug. 27 (HealthDay News) -- Perinatal stroke is more common than previously reported and its characteristics differ in acutely and retrospectively diagnosed children, according to the results of a study conducted in Estonia and published in the August issue of Stroke.

Tiina Talvik, Ph.D., of Tartu University Hospital in Tartu, Estonia, and colleagues identified 38 cases of ischemic and hemorrhagic perinatal stroke -- including 12 diagnosed acutely and 26 diagnosed retrospectively -- that occurred in Estonia between 1994 and 2003.

The researchers calculated that the Estonian incidence rate of perinatal stroke is 63 per 100,000 live births. In neonates, they found that clinical symptoms included seizures, abnormalities of muscular tone, and disturbed level of alertness. They also found that acutely diagnosed children were more likely than retrospectively diagnosed children to have experienced adverse events during pregnancy and to develop a more severe stage of hemiparesis.

"One-third of cases present with neonatal seizures, which lead to further investigations and early diagnosis of perinatal stroke," the authors conclude. "The other two-thirds do not develop neurologic symptoms in the immediate postnatal period and are diagnosed later when hemiparesis or seizures are noted and neuroimaging reveals evidence of a remote vascular event. Motor outcome is worse after the early diagnosis of perinatal stroke, and one-third of children both with early and late diagnosis of perinatal stroke develop epilepsy."

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