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Journal of Child Neurology, Vol. 23, No. 3, 279-286 (2008)
DOI: 10.1177/0883073807309246
© 2008 SAGE Publications

Cerebral Palsy After Perinatal Arterial Ischemic Stroke

Meredith R. Golomb, MD, MSc

Division of Pediatric Neurology, Indiana University School of Medicine, mgolomb{at}iupui.edu

Bhuwan P. Garg, MBBS

Division of Pediatric Neurology, Indiana University School of Medicine

Chandan Saha, PhD

Division of Biostatistics Indiana University School of Medicine

Faouzi Azzouz, MSc

Division of Biostatistics Indiana University School of Medicine

Linda S. Williams, MD

Department of Neurology, Indiana University School of Medicine, Roudebush Veterans' Affairs Medical Center Health Services Research and Development Service, Regenstrief Institute Indianapolis, Indiana

The frequency of cerebral palsy, degree of disability, and predictors of disability were assessed in children in a perinatal arterial stroke database. Risk factors were assessed at the univariate level using the Pearson {chi}2 and Fisher exact test and at the multivariate level using logistic regression analysis. Seventy-six of 111 children with perinatal stroke (68%) had cerebral palsy, most commonly hemiplegic (66/76; 87%). Multivariate analysis of the entire cohort showed both delayed presentation (OR,9.96; 95% CI, 3.10-32.02) and male sex (OR, 2.55; 95% CI, 1.03-6.32) were associated with cerebral palsy. In subgroup multivariate analyses: in children with neonatal presentation, bilateral infarcts were associated with triplegia or quadriplegia (OR, 5.33; 95% CI, 1.28-22.27); in children with unilateral middle cerebral artery infarcts, delayed presentation (OR, 10.60; 95% CI, 2.28-72.92) and large-branch infarction (OR, 8.78; 95% CI, 2.18-43.67) were associated with cerebral palsy. These data will aid physicians in planning long-term rehabilitative care for children with perinatal stroke.

Key Words: cerebral palsy • outcomes • perinatal • arterial ischemic stroke


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