Perinatal Stroke as an Etiology of Cerebral Palsy

Cerebral palsy is a group of heterogeneous disorders with a broad range of developmental outcomes and a spectrum of neurologic impairment. In the past, several studies had suggested thrombophilia as an etiology for perinatal stroke. However, as new evidence accumulates, we know that perinatal stroke is due to multifactorial etiologies. Multiple fetal and maternal risk factors can contribute to a thrombophilic microenvironment: infections, trauma, cardiac disorders, blood disorders, and placental disorders. Thus, the evaluation of a pediatric patient with perinatal stroke should include a comprehensive workup assessing the mother, infant, and, if possible, the placenta. Currently, there is no strong evidence for treatment with antiplatelet or antithrombotic agents for patients with perinatal stroke except for those with a cardiac comorbidity or venous sinus thrombosis. The overall treatment is largely supportive care. The focus of preventative care is on improving the quality of life for the pregnant mother as well as the child and maintaining a heart-healthy lifestyle to prevent secondary cardiac etiologies. Future research is needed to further evaluate possible etiologies, such as maternal risk factors, environmental risk factors, and fetal risk factors, as they relate to the timing of insult to the developing fetus.