What is a Perinatal Stroke?
When we think of someone suffering a stroke, we tend to think of someone older, likely someone with high blood pressure. The reality is that while strokes are more common among older people, anyone can have one—even a newborn baby. What is a perinatal stroke? Is it the same thing as a neonatal stroke? What causes stroke in newborns? And if your baby has had a stroke, what does that mean for their future?
A stroke results from poor blood flow to certain areas of the brain, which in turn causes damage ranging from mild and temporary to severe and permanent. In effect, a stroke is a "brain attack" in the same sense that impaired blood flow to the heart muscle causes a heart attack.
A perinatal stroke results from factors prior to an infant's delivery; a neonatal stroke is caused by events taking place during the infant's delivery. A perinatal stroke may also be called a prenatal stroke or a fetal stroke.
The Difference Between Perinatal and Neonatal Stroke
The Children's Hemiplegia and Stroke Association estimates that perinatal stroke occurs in one of every 2800 births, but concedes that this may be a conservative estimate. A perinatal stroke may be discovered via ultrasound even before delivery, if a stain is visible in the amniotic fluid.
The cause of perinatal stroke is not always clear. Risk factors include infection, maternal cocaine use, maternal diabetes, or smoking while pregnant. Under some circumstances, the effects of perinatal stroke can be avoided or minimized if an obstetrician recognizes the signs of stroke on an ultrasound and performs a Caesarian section (C-section). Up to 25% of perinatal strokes are fatal.
Sometimes, it is not possible to detect a perinatal stroke before birth. Because screening for this condition is not universal, there may not be a recent ultrasound from which to diagnose the condition. However, if a perinatal stroke has caused severe enough neurological damage, this should be apparent immediately after birth; a stroke in the left hemisphere, for instance, will manifest as weakness in the infant's right-side extremities. Seizures, which may look like staring or paused breathing, are also a common early sign of perinatal stroke. Other signs include weakness or lack of use of one side of the body (hemiparesis), or showing a consistent preference for one hand before the age of 18 months.
Neonatal strokes are those that occur during birth and up to a month afterward. Unlike perinatal strokes, symptoms of a neonatal stroke may not be evident for months after the baby is born. Up to half of all infants who have experienced a neonatal stroke appear normal during the newborn period. Signs and symptoms of neonatal stroke that eventually emerge may include hemiparesis, headaches, vomiting, language or speech delays, vision problems, or restricted movement of arms or legs.
Many, though not all, neonatal strokes are caused by negligence (medical malpractice) on the part of medical personnel during the birth. Defense attorneys may try to characterize a neonatal stroke as a perinatal stroke in order to suggest that it was caused by factors other than obstetrical negligence.
What to Do If You Suspect Your Baby Has Had a Stroke
If you suspect your baby has experienced either a perinatal stroke or a neonatal stroke, the first thing to do is to consult your pediatrician. Blood tests, MRI, CT scans, and spinal tap may be among the tests used to diagnose your child’s condition. Of course, your doctor will observe your child and take a thorough health history in order to select the most helpful tests.
Depending on what testing reveals, the level of neurological damage, and the time that has elapsed since the stroke, there are various treatments available. If stroke is detected immediately, surgery may be needed, or doctors may act to relieve pressure on the brain. Anti-seizure or anticoagulant (anti-blood clotting) medications may be called for both immediately after a stroke and longer-term. Since infants who have experienced stroke may have speech and language and cognitive deficits as well as physical weakness and sensory issues, various ongoing therapies may be recommended.
Some infants who have experienced perinatal or neonatal stroke will recover much of their physical and cognitive function, but some will not, and may need costly ongoing therapies. This can place a tremendous financial burden on a family. Unfortunately, by the time you are fully aware of what your child needs, it may be too late to investigate whether the stroke was caused by negligence, or to make a claim. That is why you should also consult an experienced Oregon birth injury attorney as soon as possible. An experienced attorney will help you evaluate whether there may be a claim worth pursuing, and assist you in filing a claim before the statute of limitations expires.
If you suspect that your infant or newborn may have suffered a stroke, we invite you to contact Huegli Fraser to schedule a consultation.
The information in this blog post is provided for informational purposes only and is not intended to be legal advice. You should not make a decision whether or not to contact a qualified medical malpractice attorney based upon the information in this blog post. No attorney-client relationship is formed nor should any such relationship be implied. If you require legal advice, please consult with a competent medical malpractice attorney licensed to practice in your jurisdiction.