The message is ready to be sent with the following file or link
attachments:

Shortcut to: http://www.eurekalert.org/pubnews.php
 Public release date: 11-Jul-2005
[ Print Article | E-mail Article | Close Window ]

Contact: David Greenberg
[log in to unmask]
201-748-6484
John Wiley & Sons, Inc.

Most perinatal strokes lead to neurologic disorders
Four of five newborn infants who experience a stroke around the time of
birth will develop neurologic disorders such as cerebral palsy,
epilepsy, or language delay, according to a study published online July
11, 2005, in the Annals of Neurology
(http://www.interscience.wiley.com/journal/ana).
"Previous studies suggested that approximately half of all infants with
stroke at or near the time of birth have a normal outcome," said senior
author Yvonne Wu, MD, MPH, a child neurologist at the University of
California, San Francisco (UCSF). "We report a higher rate of
significant long-term neurologic impairment."

This is the first study of neurologic outcomes following perinatal
arterial stroke that includes all infants diagnosed within a large
population. Researchers at UCSF and their collaborators at the Northern
California Kaiser Permanente Medical Care Program examined the medical
records of more than 199,000 children born within the managed care
program between 1997 and 2002.

The overall rate of strokes during labor and delivery, or in the month
after birth, was about 1 in 5,000 live births. However, the authors note
that the study likely missed some cases, since strokes must be confirmed
by brain imaging, a procedure that some children with subtle neurologic
symptoms do not undergo.

The most common disability, found in 58 percent of perinatal stroke
survivors, was cerebral palsy, a catch-all category that describes
children with problems ranging from clumsy movement to severe weakness
that may confine children to wheelchairs.

"Not surprisingly, we found that a larger extent of brain injury, and
injury to specific areas of the brain that control movement were both
factors that increased the risk of cerebral palsy," said Wu.

Other abnormal outcomes included epilepsy (39 percent), language delay
(25 percent), and behavioral abnormalities such as hyperactivity (22
percent).

An interesting finding was that cerebral palsy was more likely to occur
in infants who had no symptoms early in life. In such cases, the stroke
was typically discovered months after birth when the child was noted to
have diminished use of one hand. These children were more likely to have
sustained injury to deep structures of the brain that control movement.

The cause of stroke in babies is poorly understood, and is currently
under investigation in several ongoing large studies of newborn stroke
in the U.S., Canada, and Europe.

"Our data do not directly impact the current treatment of perinatal
stroke," said Wu. The authors did not find a single case of stroke
recurrence, supporting the argument that these children should not be
placed on prophylactic anti-stroke medicines.

"However, we hope to raise awareness of this disorder," said Wu.
"Infants with unexplained seizures or weakness on one side of the body
should be evaluated by a neurologist, and should receive a head imaging
study to evaluate for perinatal stroke."


###
Article: "Predictors of Outcome in Perinatal Arterial Stroke: A
Population-Based Study," by Janet Lee, Lisa A. Croen, Camilla Lindan,
Kendall B. Nash, Cathleen K. Yoshida, Donna M. Ferriero, A.J. Barkovich,
and Yvonne W. Wu, Annals of Neurology, Published Online: July 11, 2005
(DOI: 10.1002/ana.20557).

The Annals of Neurology, the preeminent neurological journal worldwide,
is published by the American Neurological Association, the world's
oldest and most prestigious neurological association. The 1,500 members
of the ANA--selected from among the most respected academic neurologists
and neuroscientists in North America and other countries--are devoted to
furthering the understanding and treatment of nervous system disorders.
For more information, visit www.aneuroa.org.





------------------------------------------------------------------------
--------
 [ Print Article | E-mail Article | Close Window ]



Note: To protect against computer viruses, e-mail programs may prevent
sending or receiving certain types of file attachments.  Check your
e-mail security settings to determine how attachments are handled.


begin 666 pubnews.url
M6TEN=&5R;F5T4VAO<G1C=71=#0I54DP]:'1T<#HO+W=W=RYE=7)E:V%L97)T
M+F]R9R]P=6)N97=S+G!H< T*36]D:69I960]-S P,$-&,SDR,#@V0S4P,44T
"#0H`
`
end