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The review by Mailo, et al. provides an excellent contemporary summary of each of the perinatal stroke entities as well as a useful algorithm to diagnose and investigate underlying stroke etiologies. This review adds new insights by highlighting the definitive imaging modalities for the diagnosis of each stroke type, discussing the often-overlooked diagnosis of periventricular venous infarction, providing a thorough explanation of outcomes, and reviewing both traditional therapies as well as the future of perinatal stroke care. Unlike most prior reviews in this area, the authors give specific attention to the parental and family impact of a stroke diagnosis with reference to family-oriented resources, which provide critical information for all medical providers who care for these neonates and their families.

From our perspective as neonatologists, perinatal stroke is not an uncommon diagnosis, but it is always recognized as a fait accompli in otherwise healthy, term neonates 1. The lack of specific factors to predict its occurrence contribute to the need for a high index of suspicion to diagnose perinatal stroke in a timely fashion 2. Protocols, like the ones proposed in this review, provide an invaluable tool to effectively navigate the diagnostic path and treatment algorithm for perinatal stroke. In the hours or days following birth, neonates with perinatal stroke may present with abnormal movements with concerns or seizures, vital sign changes, or overt encephalopathy. With these signs, the neonate requires immediate stabilization and treatment. Neonates with perinatal stroke can be born at hospitals with advanced imaging capabilities and the benefits of a …