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23 Cards in this Set
- Front
- Back
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Risks for perinatal stroke
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History of infertility
Vacuum extraction Primiparity (first child) Emergency c-section Chorioamnionitis (placental infection) Preeclampsia (hypertension plus kidney problems) Infection during pregnancy Twin gestation Advanced maternal age |
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Common regions for perinatal stroke
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left MCA - in term infants (identified by seizure or hemiplegia emering at 1 mont)
periventricular hemorrhage infarctions - in preterm infants (identified via routine ultrasound) |
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Fetal/neonatal risk factors for stroke
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Fetal heart rat abnormalities during birth
Asphyxia Low apgar scores Resuscitation at birth Cardiac anomalies Polycythemia (excess red cells) Infection Coagulation abnormalities Smallness for gestational age |
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Percent of term perinatal strokes that present with seizures
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75%
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Percent of perterm perinatal strokes that are discovered incidentally
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70%
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Percent of perinatal strokes with cerebral palsy
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40-60%
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Percent of perinatal strokes with epilepsy
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40%
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Percent of perinatal strokes with behavioral problems
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20%
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Percent of perinatal strokes who present as neurologically normal
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30-50%
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Risk factors for poor outcome in perinatal stroke
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abnormal exam at discharge from nursery, neonatal seizures, abnormal EEG, blood clotting abnormalities, and late presentation of CP
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Hemiplegic gait
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CIRCUMDUCTING; that is the body position is crouched and the impaired legs lifts and swigs
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MRI findings in perinatal stroke
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Thinning of corpus callosum (could result in abnormalities for uninjured side as well)
Low white matter in lobar region contralateral to injury site |
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IQ changes over time in perinatal stroke
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Tthe gap between IQ levels of children with PS and TD may be expected to widen over time as complexity demands increase
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Language in perinatal stroke
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Delays
Early RH injury resulted in greatest deficits in comprehension Left posterior temporal damage was associated with deficits in word and grammatical production However, show normal developmental course of language development By middle school PS children perform in the low normal age |
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The "where" visual system in perinatal stroke
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Occipital-parietal cortex
Left - dominant for categorical spatial relations Right - dominant for coordinate spatial relations (precise metric information about location) Deficits seen in PS children but with remarkable plasticity with normalization by the age of 5 |
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Face processing in perinatal stroke
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Affected by early LH or RH injury - face processing is established early and may not be so plastic, especially for children with RH lesions
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Reorganization of the motor system after perinatal stroke
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If small lesion, see intact crossing of corticospinal from injured hemisphere to paretic limb
(Sensory functions do not show same reorganization) If large lesion, rely on that small portion of corticospinal track that does not cross If intermediate lesion, see both |
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White matter abnormalities after perinatal stroke
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Reduced corpus callosum size (related to sections that would have connected affect side to other hemisphere)
Reduced white matter volume in uninjured side |
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Language development after perinatal stroke
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Order of emergence of skills is the same
Delays at each new level of linguistic challenge, regardless of which hemisphere is involved, later mastery and movement on to next challenge |
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Language lateralization after perinatal stroke
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In RH stroke, left hemisphere remains dominant for language
In LH stroke, bilateral representations emerge; if the LH remains involved, rather than more RH involvement, the better the language functioning |
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Visual pattern processing after perinatal stroke
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Visual pattern processing in RH stroke: Retention of local detail processing subserved by LH “what” network, not global processing
Visual pattern processing in LH stroke: Retention of global characteristics subserved by RH “what” network, with paucity of details (for example on Rey) |
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Lateralization of visual spatial processing after perinatal stroke
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unlike language, it becomes lateralized to non-injured side
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Effects of perinatal stroke on emotion expression
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RH injury show increased negative affect and fewer/less fluent positive affect, as compared to LH stroke and controls
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