Long-term neurodevelopmental outcome of neonates born at term with perinatal haemorrhagic stroke: A population-based study.
Eszter Vojcek, Rózsa Gráf, Anna M László and 2 others
PMID 35137402WHAT IT FOUND
Most infants with perinatal haemorrhagic stroke had lasting neurodevelopmental issues.
Parietal lobe involvement strongly predicted cerebral palsy and cognitive deficits. Frontal lobe strokes showed no motor or basic cognitive impairment, suggesting better outcomes for that group.
Key findings
01In 50 children with follow-up, 40% developed normally, but the majority had chronic sequelae, most commonly behavioural problems (24%), epilepsy (22%), and language disorders (18%).
02Parietal lobe stroke was a significant independent predictor of cerebral palsy and cognitive deficit, while thalamus or basal ganglia involvement predicted epilepsy.
03None of the infants with frontal lobe stroke developed cerebral palsy, cognitive impairment, or epilepsy during the follow-up period.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTsWhat it means for SLPs
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What it does not show
The study was partly retrospective and conducted at a single centre, limiting generalisability. Follow-up ended at early school age, so higher cognitive functions regulated by the frontal lobe (e.g., impulse control, social interaction) may not yet have been fully assessed. Two children with frontal lobe strokes were lost to follow-up before 24 months, potentially missing a diagnosis of cerebral palsy. The sample size was small (55 infants), particularly for subgroup analyses of rare stroke locations. Bleeding diathesis was not investigated in all patients, leaving some aetiologies unexplained.
Declared interests
The authors declared no conflicts of interest. The study was funded by Semmelweis Egyetem.
The easy way to misread this
Do not assume that a frontal lobe stroke guarantees a normal long-term outcome. The study only followed children to early school age, and higher-order frontal functions like social behaviour and impulse control often emerge later. The lack of observed deficits in this group may reflect the young age of assessment rather than true resilience.