Neonatal Stroke Birth Injuries
While strokes are usually associated with the elderly, there is also a risk of strokes before, during, and shortly after childbirth. Children who suffer from a neonatal stroke may have permanent cognitive as a result of their stroke.
The signs and symptoms are not easily detectable before childbirth. This means that many infants who experienced a stroke may go untreated. This would result in further complications such as brain damage, cerebral palsy, difficulty learning, and other disabilities.What Is a Neonatal Stroke?
A neonatal stroke occurs when blood flow to an infant's brain is interrupted or blocked within the first 28 days after birth. If the stroke occurred within the first seven days, it is referred to as a perinatal stroke. During a neonatal stroke, the brain experiences oxygen deprivation and blockage to the blood vessels. The neonatal stroke occurrence rate is about 1 in 4,000 babies. However, the actual occurrence rate may be higher because of how difficult it is to detect a neonatal stroke.What Are the Causes and Factors of a Neonatal Stroke?
There are several different causes and factors that can lead to a neonatal stroke. One cause is hypoxia, which occurs when a baby is deprived of oxygen. This can cause the brain to experience irregular activity. The mother's overall health can also affect whether or not her child might experience a stroke. If she has a history of conditions such as autoimmune disorders, coagulation disorders, congenital heart disease, diabetes, and trauma, her child would be at a higher risk of developing a neonatal stroke.
Mothers who have been using cocaine during their pregnancies will put their child at risk as well. Maternal infections that affect the central nervous system or other systemic infections can cause a neonatal stroke.
While these conditions may indicate a neonatal stroke, healthy children born in good conditions such as normal labor and delivery may experience a neonatal stroke as well. This reinforces how difficult it is to figure out whether or not a baby experienced a neonatal stroke.Neonatal Stroke Symptoms
Unfortunately, an infant may not show outward signs that they are experiencing a neonatal stroke. They may even go several months without anyone detecting something suspicious. The symptoms would only become noticeable as the child would get older. These symptoms include difficulties with speech, difficulty with balance, and numbness on a side of their body.
When a child shows an outward symptom of a neonatal stroke, it is usually a seizure. However, seizure symptoms can be difficult to detect in newborns. These symptoms include facial movements such as sucking, chewing, or eye movement. Movements that resemble bicycling or pedaling can also be seen as well. Staring is also another symptom as well. Another symptom is when a childHow Is Neonatal Stroke Diagnosed?
A neonatal stroke can sometimes be detected while the baby is in the womb. This occurs when there may be a possibility of a birth defect. When this happens, the mother would then be given a fetal MRI, which is effective in detecting whether or the fetus had a stroke. Sometimes, the stroke might be severe enough that it could be detected through an ultrasound. Upon birth, further imaging must be performed on the child to confirm the diagnosis
Any newborn having a seizure should have their head examined via ultrasound and CT scans. MRI should also be administered as well.How Can Neonatal Strokes be Treated?
The specific interventions for a neonatal stroke depend on the particular aspect of cognitive function that was impacted by the stroke. Ultimately, it is not the specific diagnosis that is critical for the treatment of a neonatal stroke because the type of interventions that can help children are largely going to be the same as they would be for the same cognitive problem without a history of stroke.
In terms of immediate treatment for the injury, there are two ways to treat neonatal stroke. The first is therapeutic hypothermia, which administered brain cooling. The second is hyperbaric oxygen therapy.
One such way that neonatal strokes can be treated is through therapeutic hypothermia, which would be locally administered on the head. This specific administration is informally known as "brain cooling." Lowering the brain's temperature can slow brain activity down, as to prevent any further damage to it. It can prevent the brain from overheating as a result of increased blood flow. In addition, constricting blood vessels reduces the likelihood of less brain damage.
Hyperbaric oxygen therapy works by putting an infant in a pressurized room that consists of 100% oxygen. The pressurization allows for one to inhale more oxygen than if they were to breathe pure oxygen at regular air pressure conditions. This allows the infant to breathe nothing but oxygen, which can help make up for lost oxygen.
As therapeutic hypothermia and hyperbaric oxygen therapy are both relatively novel, some doctors may shy away from it. The two conventional methods of treatment are urokinase and heparin. Urokinase is an agent that comes from human neonatal kidney cells. It is administered via injection and can help treat bleeding. Heparin is an anticoagulant that helps reduce blood clotting and prevents the formation of harmful ones in blood vessels.
- Getting ahead of the game: prophylactic use of erythropoietin for neonatal stroke
What you should do is make sure your child gets medical attention as soon as possible. The sooner your child attention, the less likely they will experience even further health complications. If you suspect any remote possibility that your child has had a stroke, always contact a medical professional.How Can I Prevent my Baby From Having a Stroke?
Preventing your baby from having a stroke starts with you. Many neonatal strokes occur in pregnancy, making it very important that you take care of your own health. This helps your child receive healthy blood flow while they are still in the womb. Eat properly, refrain from smoking, and stay hydrated.
If you or your family have a history of clot-related disorders, you should be tested to see if you carry a genetic disorder known as Factor V Leiden, which may cause clotting in your baby. If doctors know that the baby might have Factor V Leiden, they can take steps to manage it.
A partial blood transfusion exchange, with blood diluted in saline, may help prevent a stroke. This can help if the baby's red blood cells count is high due to pregnancy or childbirth complications. A high red blood cell count may also cause blood clots as well.Medical Literature
- Westmacott R, et. al: Late emergence of cognitive deficits following unilateral neonatal stroke. Stroke 2009 Jun; 40(6):2012-2019.
- Kirton A, et. al: Advances in perinatal ischemic stroke. Pediatric Neurology 2009 Mar; 40(3):205-214.
- McLinden A, et. al: Early cognitive outcome after a neonatal stroke. Journal of Child Neurology 2007 Sept; 22(9):1111-1116.
- Rafay M, et. al: Predictive value of clinical and EEG features in the diagnosis of stroke and hypoxic ischemic encephalopathy in neonates with seizures. Stroke 2009 Jul; 40(7):2402-2407.