Life After Perinatal Stroke

Kirton, Adam; deVeber, Gabrielle

doi:10.1161/strokeaha.113.000739

Cited by 192 publications

(177 citation statements)

References 69 publications

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“…1,2 However, most neuroanatomical correlates of motor outcomes after NAIS were derived from lesion category-based studies, 2,3 which by definition only analyzed infarct characteristics. As motor performance after brain lesions 4,5 cannot be fully explained by infarct characteristics alone, these aforementioned methods may be insufficient to identify reliably all potential brain substrates of motor performance.…”

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confidence: 99%

Does Contralesional Hand Function After Neonatal Stroke Only Depend on Lesion Characteristics?

Dinomais

Hertz-Pannier

Groeschel

et al. 2016

Stroke

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Background and Purpose-In children having suffered from neonatal arterial ischemic stroke, the relationship between contralesional hand performance and structural changes in brain areas remote from the infarct site was examined. Methods-Using voxel-based morphometry, we correlated contralesional gross manual dexterity assessed by the box and block test and whole-brain gray and white-matter volume changes on high-resolution magnetic resonance imaging in 37 7-year-old post-neonatal arterial ischemic stroke children. We also compared the volume of the identified structures with magnetic resonance imaging data of 10 typically developing age-matched children. Results-Areas showing the highest positive correlation with the box and block test scores were ipsilesional mediodorsal thalamus, contralesional cerebellar lobule VIIa Crus I, and ipsilesional corticospinal tract at the level of superior corona radiata, the posterior limb of the internal capsule, and the cerebral peduncle and the ipsilesional body of corpus callosum. When compared with typically developing age-matched children, post-neonatal arterial ischemic stroke children with severe contralesional hand motor deficit exhibited significant volume reductions in these structures (except the cerebellum), whereas no differences were found with those with good manual dexterity. No negative correlation was found between box and block test scores and brain areas. Conclusions-Contralesional hand performance after neonatal arterial ischemic stroke is correlated with atrophy in brain areas directly or functionally connected but anatomically remote from the infarct. Our study suggests a role of the cerebellar lobule VIIa Crus I and mediodorsal thalamus in manual dexterity. Clinical Trial Registration-URL: https://clinicaltrials.gov. Unique identifier: NCT02511249.

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mentioning

confidence: 99%

Does Contralesional Hand Function After Neonatal Stroke Only Depend on Lesion Characteristics?

Dinomais

Hertz-Pannier

Groeschel

et al. 2016

Stroke

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“…1 Disease-specific subtypes of perinatal stroke are now definable based on clinical presentation and neuroimaging including vascular distribution. 2,3 Most common are arterial ischemic strokes, but fetal venous infarcts also occur.…”

Section: Introductionmentioning

confidence: 99%

Thrombophilia risk is not increased in children after perinatal stroke

Curtis

Mineyko

Massicotte

et al. 2017

Blood

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Key Points• Thrombophilia in children with perinatal stroke is rare, with rates similar to those in the normal population.• Routine testing in childhood is not indicated.Perinatal stroke causes cerebral palsy and lifelong disability. Specific diseases are definable, but mechanisms are poorly understood. Evidence suggests possible associations between arterial perinatal stroke and prothrombotic disorders, but population-based, controlled, disease-specific studies are limited. Understanding thrombophilia in perinatal stroke informs pathogenesis models and clinical management.We conducted a population-based, prospective, case-control study to determine the association of specific perinatal stroke diseases with known thrombophilias. Children with idiopathic magnetic resonance imaging-classified neonatal arterial ischemic stroke (NAIS), arterial presumed perinatal ischemic stroke (APPIS), or fetal periventricular venous infarction (PVI) were recruited. Standardized thrombophilia evaluations were performed after 12 months of age on stroke cases and controls, including quantified proteins C and S, antithrombin, factors VIII/IX/XI, fibrinogen, lipoprotein(a), homocysteine, lupus anticoagulant, anticardiolipin antibodies and genotyping of factor V Leiden (FVL), factor II G20210A (FII), and methylenetetrahydrofolate reductase C677T. A total of 212 children were studied: 46 with NAIS, 34 with APPIS, 55 with PVI, and 77 controls (male, 53%; median age, 4.8 years). Of 14 parameters, no differences were observed in 12, including all common thrombophilias. Mean prothrombin time was shorter in arterial strokes (P < .001). Rates of antiphospholipid antibodies were low, comparable to those in controls, and resolved on repeat testing. FVL and FII rates were comparable to population norms. Total number of possible abnormalities did not differ between cases and controls. Our prospective, population-based, controlled, disease-specific study suggests minimal association between perinatal stroke and thrombophilia. This does not exclude the possibility of disordered coagulation at the time of stroke but suggests testing in childhood is not indicated. (Blood. 2017;129(20):2793-2800 Medscape Continuing

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“…Lifetime risk of stroke is highest in the perinatal period (Mineyko & Kirton, 2011), with arterial PS occurring in approximately 1 in 4000 live births (Lynch & Nelson, 2001). Children with PS have been extensively studied in the medical (Harbert, Jett, Appelbaum, Nass, & Trauner, 2012;Kirton, 2013) and psychological literature (Murias, Brooks, Kirton, & Iaria, 2014;Stiles, Reilly, Paul, & Moses, 2005) and informed our understanding of neuroplasticity in the developing brain (Stiles et al, 2012). Below, we review what is known about language development subsequent to PS.…”

Section: Perinatal Stroke and Language Developmentmentioning

confidence: 99%