Fall 2005

Perinatal Strokes Cause Long-Term Impairment

A recently published study by UCSF researchers revealed that four out of five newborns who experience intracerebral arterial infarction at birth will later develop neurological disorders such as cerebral palsy, epilepsy or language delay.

The research, headed by pediatric neurologist Yvonne Wu, M.D., M.P.H., in collaboration with the Kaiser Permanente Division of Research, uncovered a higher rate of long-term neurological impairment than previously described. Past literature suggests that about half of infants with perinatal arterial infarction can expect a normal neurologic outcome. The new numbers reported by Wu may be more accurate because this is the first study that includes all infants diagnosed within a large population.

The researchers examined the records of almost 200,000 children born between 1997 and 2002. The overall rate of ischemic stroke in the newborn period was about one in 5,000 live births.

The most common adverse outcome following perinatal arterial stroke was cerebral palsy, which was found in 58 percent of survivors. Cerebral palsy was more likely to occur in infants who had a large stroke size and who sustained injury to the internal capsule or basal ganglia. The researchers also found that infants who had no symptoms at birth, but who were diagnosed with perinatal stroke months later, were also more likely to have cerebral palsy.

The new research follows up other UCSF research by pediatric neurologist Donna Ferriero, M.D., who demonstrated three years ago that stroke among neonates and children is severely underrecognized. Although it was once thought that stroke among newborns is exceedingly rare, Ferriero's research and the more recent study show that the risk of stroke in newborns is as high as the risk of large-vessel ischemic stroke in adults.

To contact Dr. Wu, call (415) 353-2525.


1. Lee J., Croen L.A., Lindan C., Nash K.B., Yoshida C.K., Ferriero D.M., Barkovich A.J., Wu Y.W. Predictors of outcome in perinatal arterial stroke: A population-based study. Ann Neurol. 2005 Aug;58(2):303-308.

2. Lee J., Croen L.A., Backstrand K.H., Yoshida C.K., Henning L.H., Lindan C., Ferriero D.M., Fullerton H.J., Barkovich A.J., Wu Y.W. Maternal and infant characteristics associated with perinatal arterial stroke in the infant. JAMA. 2005 Feb 9;293:723-729.

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