A perinatal ischemic stroke may not be detected until later in infancy when one or more clinical findings develop. The diagnosis may be delayed after the initial presentation if findings are mild and nonspecific.
Clinical findings may include:
(1) seizures
(2) asymmetrical early motor development
(3) early hand preference
(4) nonmotor developmental delay
A parent is often the first to suspect a problem.
Factors associated with shorter delay in diagnosis:
(1) family history of hypercoagulability
(2) history of a perinatal problem
(3) more severe clinical findings
The diagnosis involves an abnormality in a CNS imaging study. It is presumed to be perinatal if:
(1) imaging changes indicate a remote event
(2) (no event after neonatal period) AND (some perinatal event documented)
