Acute Perinatal Stroke Characteristics and Outcome in Southern Finland.

Abstract

Aim: Perinatal stroke can cause lifelong morbidities. Outcome prediction is important for parental guidance and follow-up. We studied characteristics of acute perinatal stroke in a Finnish cohort.

Methods: We performed a population-based study, identifying infants with acute neonatal cerebral ischemia or sinovenous thrombosis (CSVT) in Southern Finland from 2010 to 2023. We analysed the incidence of stroke types, seizures, anti-seizure medication use, and outcomes.

Results: Altogether 88 infants (1 in 3101 live births) were diagnosed with acute perinatal stroke: 67% with arterial ischemic stroke (AIS), 22% with hemorrhagic stroke (HS) and 11% with CSVT. Seizures and anti-seizure medication use occurred in 78% of infants. Cranial ultrasound infrequently recognized AIS but usually noted haemorrhage. During follow-up, 34% of infants had no adverse outcome diagnosis. The most common outcome was cerebral palsy (CP, 35%). A combination of CP with epilepsy or seizures was more frequent in infants with AIS than in those with other stroke types.

Conclusion: The distribution of stroke types, symptoms, and adverse outcomes aligns with the previous literature. Acute seizures were common in AIS and HS patients. No recurrent strokes occurred during follow-up and underlying infant-related etiologies were rarely identified.