Perinatal arterial ischemic stroke and periventricular venous infarction in infants with unilateral cerebral palsy

Aim To explore clinical factors associated with perinatal arterial ischemic stroke (AIS) and periventricular venous infarction (PVI) in infants who develop unilateral cerebral palsy (CP). Method This was a case–control study. Data current to 2019 was extracted from the Canadian Cerebral Palsy Regist...

Full description

Saved in:
Bibliographic Details
Published in:Developmental medicine and child neurology 2022-01, Vol.64 (1), p.56-62
Main Authors: Vitagliano, Melissa, Dunbar, Mary, Dyck Holzinger, Sasha, Letourneau, Nicole, Dewey, Deborah, Oskoui, Maryam, Shevell, Michael, Kirton, Adam
Format: Article
Language:English
Subjects:
Brain - diagnostic imaging
Case-Control Studies
Cerebral Palsy - diagnostic imaging
Cerebral Palsy - etiology
Child, Preschool
Female
Humans
Infant
Infarction - complications
Infarction - diagnostic imaging
Ischemic Stroke - complications
Ischemic Stroke - diagnostic imaging
Magnetic Resonance Imaging
Male
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Aim To explore clinical factors associated with perinatal arterial ischemic stroke (AIS) and periventricular venous infarction (PVI) in infants who develop unilateral cerebral palsy (CP). Method This was a case–control study. Data current to 2019 was extracted from the Canadian Cerebral Palsy Registry (CCPR). Cases were infants born at term with confirmed unilateral CP. Magnetic resonance images were stratified by expert review of reports as definitive perinatal stroke (AIS or PVI). Controls with common data elements were recruited from a population‐based study in Alberta. Multivariable regression analyses were performed to estimate associations expressed as odds ratios with 95% confidence intervals. Results Of 2093 cases from the CCPR, 662 had unilateral CP, of whom 299 (45%) had perinatal stroke: AIS 169 (57%) and PVI 130 (43%). Median age at diagnosis for AIS was 11.9 months (interquartile range: 6.2–25.7mo; range 0.17–104.1mo), and 58.6% were male. Median age at diagnosis for PVI was 25.3 months (interquartile range: 14.5–38mo, range 0.7–114.7mo) and 57.7% were male. Independent associations for both AIS and PVI on multivariable analysis were chorioamnionitis, illicit drug exposure, diabetes, gestational age, and maternal age. Variables associated with AIS alone were low Apgar score and prolonged rupture of membranes. Variables associated with PVI alone were small for gestational age and primigravida. Interpretation Controlled analysis of disease‐specific unilateral CP may offer unique perspectives on its pathophysiology. Acute intrapartum factors are mainly associated with AIS, while in utero factors are associated with PVI. This original article is commented by Ganesan on page 9 of this issue.
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.15000