Hemiplegic Cerebral Palsy: Clinical Features Associated With Arterial Ischemic Stroke or Periventricular Venous Infarction

Objective We sought to determine the clinical features of hemiplegic cerebral palsy associated with perinatal arterial ischemic stroke or periventricular venous infarction. Methods We studied children with hemiplegic cerebral palsy enrolled at 9 rehabilitation centers across Ontario. We compared children with underlying perinatal arterial ischemic stroke or periventricular venous infarction on clinically acquired brain imaging. Analysis also included prenatal (maternal, prenatal/gestational) and perinatal (obstetrical, neonatal) clinical features collected from birth records and standardized parent interviews. Results The 144 children with hemiplegic cerebral palsy (62% male) included 95 with perinatal arterial ischemic stroke and 49 with periventricular venous infarction. In this cohort of children with hemiplegic cerebral palsy, we found neonatal systemic thrombosis (ie, blood clots in the body) ( P = .05), emergency cesarean section ( P = .05), and neonatal seizures ( P = .01) to be clinical features associated with hemiplegic cerebral palsy in children with perinatal arterial ischemic stroke more often than periventricular venous infarction. Preterm delivery rates were similar for perinatal arterial ischemic stroke and periventricular venous infarction. Conclusion We determined clinical features associated with the 2 most typical forms of focal ischemic brain injury in children with hemiplegic cerebral palsy, including mode of delivery emergency cesarean section, neonatal seizures and systemic thrombosis. These findings provide further insight and support for existing findings about focal brain injury patterns leading to hemiplegic cerebral palsy in children.