Stroke involves the death of brain cells caused by a disruption in blood flow to the brain. People often associate stroke with elderly people, but fetuses and babies may suffer from stroke before or after childbirth. This is known as perinatal stroke, which typically occurs between 20 weeks of gestation and four weeks after birth. Sometimes stroke accompanies hypoxic ischemic encephalopathy (HIE), which arises in similar circumstances.
Red Blood Cells and Stroke Risk
Infants face a higher risk of stroke because they have thicker blood due to a higher red blood cell count, which can lead to clots.
Stroke typically occurs due to hemorrhages or blood clots that alter the flow of blood and reduce the oxygen supply of a child. Causes include birth defects and post-delivery infections that can result in clots or allow clots to travel more easily to the brain. In other situations, though, birth trauma involving the improper use of vacuum extraction devices, forceps, or other instruments may put pressure on the head that results in clotting, hemorrhages, and strokes. Pressure on the placenta, uterus, or umbilical cord may have similar effects. Moreover, a doctor may not recognize and address pregnancy complications, increasing the risk of stroke.
Symptoms and Diagnosis of Perinatal Stroke
Initial signs of a perinatal stroke may include problems with breathing or feeding, seizures, partial weakness on one side of the body, altered mental state, and decreased or otherwise abnormal muscle tone. If a child seems to develop right or left handedness, this may indicate asymmetrical weakness resulting from a stroke. Most children do not establish handedness until after the first year of life.
Tests for diagnosing a stroke include brain imaging, such as MRIs or CT scans. If a doctor suspects a fetal stroke, they might perform an ultrasound on the fetal brain. Blood tests and lumbar punctures that analyze spinal cord fluid can help a doctor determine whether a child suffers from an infection, or whether a hemorrhage or clot has developed. A doctor may look at blood vessels through magnetic resonance arteriograms or venograms.
Electroencephalography also can help diagnose a perinatal stroke by placing electrodes on the scalp to measure electrical activity in the brain.
Treatment for Perinatal Stroke
To address the brain damage caused by a perinatal stroke, a doctor may provide hypothermia therapy (brain cooling) to an infant. This reduces the temperature and metabolic rate of the brain so that it can recover on its own. While hypothermia therapy does not always work, prompt administration as soon as a stroke is diagnosed can prevent severe disabilities. Other potential treatments may include:
Hydration through IV fluids
Seizure medication (anti-convulsants) if the child suffers from seizures
Blood thinners for strokes caused by clotting, which may reduce the risk of further clots and strokes caused by existing brain damage
Legal Claims Based on Perinatal Stroke
Some children suffer only moderate effects from a perinatal stroke. This is because healthy areas of the brain may take over functions normally controlled by damaged areas. Other children are less fortunate and develop severe disabilities, potentially including cerebral palsy, seizures, and developmental delays. Treatment for these conditions may involve therapies, medications, assistive devices, and surgeries, which can be expensive. If a perinatal stroke or complications from a stroke resulted from errors by a health care provider, parents should consider bringing a medical malpractice lawsuit. This can provide them with compensation for past, present, and future medical costs, as well as the pain and suffering endured by the child.
Medical malpractice cases usually rely on testimony from experts, such as doctors in the same specialty as the defendant. Expert witnesses can describe the professional standard of care that would have applied to the defendant physician. They also can identify the error that fell short of the standard of care and discuss its impact on the child. Retaining expert witnesses and handling other sophisticated aspects of these cases tends to be challenging without an attorney. As soon as a parent suspects medical malpractice, therefore, they should set up free consultations with birth injury lawyers in their area to find out whether they may have a claim.