Early intervention after perinatal stroke: opportunities and challenges

Perinatal stroke is the most common cause of hemiplegic cerebral palsy. No standardized early intervention exists despite evidence for a critical time window for activity‐dependent plasticity to mould corticospinal tract development in the first few years of life. Intervention during this unique per...

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Bibliographic Details
Published in:Developmental medicine and child neurology 2014-06, Vol.56 (6), p.516-521
Main Author: Basu, Anna P
Format: Article
Language:English
Subjects:
Animals
Cerebral Palsy - congenital
Cerebral Palsy - diagnosis
Cerebral Palsy - physiopathology
Cerebral Palsy - rehabilitation
Child
Child, Preschool
Disease Models, Animal
Early Diagnosis
Early Medical Intervention
Exercise Movement Techniques
Hemiplegia - congenital
Hemiplegia - diagnosis
Hemiplegia - physiopathology
Hemiplegia - rehabilitation
Humans
Hypothermia, Induced
Infant
Infant, Newborn
Neuronal Plasticity - physiology
Prognosis
Pyramidal Tracts - physiopathology
Stem Cell Transplantation
Stroke - congenital
Stroke - diagnosis
Stroke - physiopathology
Stroke Rehabilitation
Transcranial Magnetic Stimulation
Translational Research, Biomedical
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Summary:Perinatal stroke is the most common cause of hemiplegic cerebral palsy. No standardized early intervention exists despite evidence for a critical time window for activity‐dependent plasticity to mould corticospinal tract development in the first few years of life. Intervention during this unique period of plasticity could mitigate the consequences of perinatal stroke to an extent not possible with later intervention, by preserving the normal pattern of development of descending motor pathways. This article outlines the broad range of approaches currently under investigation. Despite significant progress in this area, improved early detection and outcome prediction remain important goals. What this paper adds Experimental approaches targeting early therapeutic time windows after perinatal stroke have the potential for significant reduction of morbidity. Improved early detection rates and optimized outcome prediction will be needed to implement all but the most low‐risk interventional strategies.
ISSN:0012-1622
1469-8749
DOI:10.1111/dmcn.12407