Life After Perinatal Stroke

Life after perinatal stroke can certainly be good. The high level of functioning attained by many children despite large brain lesions is a remarkable testament to the potential power of developmental plasticity. However, it is clear that such early injury places many other children on an abnormal developmental trajectory with functional consequences. How the interplay of multiple disordered functions in individual children may combine to impact the eventual outcome is of great interest. A child with great developmental potential may be stymied by pathological electrographic brain activity during sleep. Another child highly capable of acquiring new motor skills may fail to gain practical function because proprioceptive deficits prevent him or her from knowing where his or her hand is in space. Another with normal intelligence but an attention disorder may not be able to engage in school, therapy, or sports that could each improve function. With improving recognition and measurement, an integrated understanding of how these multiple factors dictate outcomes in individual children will be a major challenge of perinatal stroke research going forward.