Clinical Features and Risk Factors of Perinatal Hemorrhagic Stroke

Hwang, Mun Jong; Park, Soo Hyun; Kim, Won Duck

Abstract

OBJECTIVE
Perinatal hemorrhagic stroke (PHS) is common cause of cerebral palsy, congenital hemiparesis, and subsequent behavioral, cognitive, and language problems. Despite of this importance, risk factors for this condition have not been studied. This study was undertaken to survey the clinical features and risk factors of PHS.
METHODS
A retrospective study was carried out on 24 newborns with PHS who were admitted to the neonatal intensive care unit (NICU) of Daegu Fatima hospital from January 2004 to July 2009. Cases of PHS in neonates (28 weeks' gestational age through 28 days of life) were identified through neuroimaging studies, clinical findings and chart review. Two controls per case were randomly selected. Risk factors of PHS were assessed and clinical features of PHS were reviewed.
RESULTS
We identified 24 cases of PHS (19 intracerebral hemorrhage, 4 intracerebral hemorrhage with subarachnoid hemorrhage, 1 subarachnoid hemorrhage). PHS was more common in male (15 males and 9 females). Case presented with encephalopathy (100%), seizures (20.8%) and cyanosis (4.2%). The neuroimaging findings of PHS were more commonly unilateral (78.3%), and right-hemisphere (73.9%). PHS was most often seen in temporal lobe (38.2%). There were no statistical and significant risk factors of PHS.
CONCLUSIONS
Newborns with PHS typically present with encephalopathy (lethargy, hypotonia, apnea, feeding disability) and seizures. The neuroimaging findings were more commonly unifocal, unilateral and seen in temporal lobe. Additional prospective studies are needed to determine the prevalence and risk factors of PHS.