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Abstract
Neonates, infants, and children all may suffer strokes. A stroke is a prolonged or permanent dysfunction of brain activity due to interruption of normal vascular flow or due to hemorrhage within the brain. Stroke symptoms that last less than 24 hours are called transient ischemic attacks Perinatal stroke occur between 28 weeks of gestation and 28 days of postnatal age while childhood stroke occur between 30 days and 18 years of age The incidence of stroke in the pediatric population is estimated at between 2 and 13 per 100,000. Boys have a higher risk of pediatric stroke than girls, with the type of stroke varying with age; infants have a higher rate of ischemic stroke, whereas older children show a higher incidence of hemorrhagic stroke. Black children have more than twice the risk of stroke of white children, Hispanic children have a lower risk than white and Asian children show a roughly equal risk At a molecular level, the development of hypoxic- ischemic neuronal injury is triggered by depletion of cellular energy stores which is needed to clear glutamate resulting in the opening of calcium channels which are responsible for activation of a series of destructive enzymes such as proteases, allowing release of cytokines and other mediators resulting in the loss of cellular integrity In perinatal stroke; risk factors include maternal disorders placental disorders, perinatal asphyxia, blood disorders, cardiac disorders, infection, trauma, and drugs, Neonatal seizures are most commonly the clinical finding that triggers assessment other systemic signs, if present, are nonspecific and sometimes subtle and include hypotonia, lethargy, or apnea.