Outcomes of Perinatal Stroke

Summary

Principal Investigator: Meredith R Golomb
Affiliation: Indiana University
Country: USA
Abstract: The primary objective of this Mentored Patient-Oriented Research Career-Development Award is to allow Meredith R. Golomb (the candidate) to develop the skills necessary to become an independent investigator in perinatal stroke research. Dr. Golomb has completed fellowships in child neurology and pediatric stroke, as well as a Masters of Science degree in Clinical Epidemiology. She wrote her MSc thesis on walking after perinatal stroke. She is an Assistant Professor at Indiana University (IU) School of Medicine, which, with its affiliated 4 hospitals, is the largest provider of tertiary pediatric care in Indiana. Dr. Golomb will take advanced classes in biostatistics, study design, and research ethics though IU's Clinical Investigator Training Program, which is funded though an NIH K30 grant, and work with investigators at the Regenstrief Institute for Health Care, which houses one of the oldest and most complete electronic medical records systems in the country. Dr. Golomb plans to describe the clinical characteristics and the motor, cognitive, and epilepsy outcomes in a retrospective cohort of all children with perinatal arterial ischemic stroke or sinovenous thrombosis seen at the IU-affiliated hospitals over the past 10 years, and to initiate a prospective cohort study documenting patient-oriented outcomes in more detail. She plans to use logistic regression modeling and Cox proportional hazards models to assess clinical characteristics as predictors of cognitive, motor, and epilepsy outcomes. The long-term goal of this study is to lay the foundation for future clinical trials of interventions designed to improve the outcomes of these children. During the last year of the study, she plans to apply for an R01 grant to set up a pilot clinical trial.
Funding Period: 2004-06-01 - 2009-05-31
more information: NIH RePORT

Top Publications

  1. ncbi Age-related variation in presenting signs of childhood arterial ischemic stroke
    Jennifer A Zimmer
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 37:171-5. 2007
  2. ncbi Epilepsy in children with delayed presentation of perinatal stroke
    Karima C Fitzgerald
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    J Child Neurol 22:1274-80. 2007
  3. doi Neuropsychologic outcomes in a case series of twins discordant for perinatal stroke
    Tasneem L Talib
    Division of Pediatric Neurology, Department of Neurology, Roudebush Veterans Affairs Medical Center Health Services, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 38:118-25. 2008
  4. pmc Very early arterial ischemic stroke in premature infants
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
    Pediatr Neurol 38:329-34. 2008
  5. ncbi Perinatal stroke in baby, prothrombotic gene in mom: does this affect maternal health insurance?
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    Neurology 65:13-6. 2005
  6. pmc Perinatal stroke and the risk of developing childhood epilepsy
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    J Pediatr 151:409-13, 413.e1-2. 2007
  7. pmc Association of cerebral palsy with other disabilities in children with perinatal arterial ischemic stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 37:245-9. 2007
  8. doi Cerebral palsy after perinatal arterial ischemic stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, 575 West Drive, Indianapolis, IN 46202, USA
    J Child Neurol 23:279-86. 2008
  9. doi Simultaneous toxicities in a child on multiple anticonvulsants
    Sarah Isis R Delima
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    J Child Neurol 23:1054-7. 2008
  10. pmc Teaching neuroImage: MRI visualization of papilledema associated with cerebral sinovenous thrombosis in a child
    Jennifer A Zimmer
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN46202, USA
    Neurology 71:e12-3. 2008

Scientific Experts

  • Meredith R Golomb
  • Linda S Williams
  • Bhuwan P Garg
  • Karima C Fitzgerald
  • Michelle E Nwosu
  • Jennifer A Zimmer
  • Laurence E Walsh
  • Karen S Carvalho
  • Erica T Ting
  • Tasneem L Talib
  • Sarah Isis R Delima
  • Mary Edwards-Brown
  • Lisa M McGuire
  • Jessica R Nance
  • Chandan Saha
  • Sheila C Johal
  • Beth A Drolet
  • Aimee J Szewka
  • Deborah K Sokol
  • George J Eckert
  • Stephen J Pongonis
  • Darren P O'Neill
  • William E DeMyer
  • Jack Sty
  • Joan Tamburro
  • Luann Murowski
  • Mark E Heiny
  • Robert Wells
  • Sheila Fallon Friedlander
  • Magdalene Dohil
  • Joel C Boaz

Detail Information

Publications34

  1. ncbi Age-related variation in presenting signs of childhood arterial ischemic stroke
    Jennifer A Zimmer
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 37:171-5. 2007
    ..These findings may aid in the recognition of stroke in young children...
  2. ncbi Epilepsy in children with delayed presentation of perinatal stroke
    Karima C Fitzgerald
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    J Child Neurol 22:1274-80. 2007
    ..Cognitive disability often accompanies epilepsy in these children...
  3. doi Neuropsychologic outcomes in a case series of twins discordant for perinatal stroke
    Tasneem L Talib
    Division of Pediatric Neurology, Department of Neurology, Roudebush Veterans Affairs Medical Center Health Services, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 38:118-25. 2008
    ..Twin gestation may be a risk factor for poor cognitive outcome after perinatal stroke. Large infarct size and comorbid epilepsy may have contributed to some of the poor cognitive outcomes in this cohort...
  4. pmc Very early arterial ischemic stroke in premature infants
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana, USA
    Pediatr Neurol 38:329-34. 2008
    ..Seventeen (77%) had cerebral palsy, 10 (45%) had epilepsy, and 17 (77%) had cognitive impairment. Arterial ischemic stroke appears to add to the neurologic disabilities commonly associated with prematurity...
  5. ncbi Perinatal stroke in baby, prothrombotic gene in mom: does this affect maternal health insurance?
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    Neurology 65:13-6. 2005
    ..Maternal prothrombotic disorders may contribute to stroke in the fetus before and during birth. Many of the mothers of children with perinatal stroke have no previous history of pathologic thrombosis...
  6. pmc Perinatal stroke and the risk of developing childhood epilepsy
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    J Pediatr 151:409-13, 413.e1-2. 2007
    ..To describe the prevalence of epilepsy after 6 months of age in children with perinatal stroke and examine whether perinatal data predict epilepsy onset and resolution...
  7. pmc Association of cerebral palsy with other disabilities in children with perinatal arterial ischemic stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 37:245-9. 2007
    ..21-69.21) than children with delayed presentation. Children with cerebral palsy after perinatal stroke are likely to have an additional disability; those with neonatal presentation are more likely to have a severe disability...
  8. doi Cerebral palsy after perinatal arterial ischemic stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, 575 West Drive, Indianapolis, IN 46202, USA
    J Child Neurol 23:279-86. 2008
    ..60; 95% CI, 2.28-72.92) and large-branch infarction (OR, 8.78; 95% CI, 2.18-43.67) were associated with cerebral palsy. These data will aid physicians in planning long-term rehabilitative care for children with perinatal stroke...
  9. doi Simultaneous toxicities in a child on multiple anticonvulsants
    Sarah Isis R Delima
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    J Child Neurol 23:1054-7. 2008
    ..This article discusses the possibility that simultaneous use of valproic acid, lamotrigine, and phenytoin could give this combination of toxicities and that concurrent viral infection may increase this risk...
  10. pmc Teaching neuroImage: MRI visualization of papilledema associated with cerebral sinovenous thrombosis in a child
    Jennifer A Zimmer
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN46202, USA
    Neurology 71:e12-3. 2008
  11. doi Neonatal sinovenous thrombosis: presentation and association with imaging
    Michelle E Nwosu
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 39:155-61. 2008
    ..Neither timing of presentation nor presence or absence of severe seizures can be used to predict findings on radiographic imaging...
  12. doi Male predominance in childhood ischemic stroke: findings from the international pediatric stroke study
    Meredith R Golomb
    Indiana University School of Medicine, Building XE 040, 575 West Drive, Indianapolis, IN 46202, USA
    Stroke 40:52-7. 2009
    ..We sought to study gender within a large international series of confirmed cases of pediatric ischemic stroke...
  13. doi Cerebral sinovenous thrombosis associated with isopropanol ingestion in an infant
    Michelle E Nwosu
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
    J Child Neurol 24:349-53. 2009
    ..To our knowledge, there have been no reports describing cerebral sinovenous thrombosis as a complication of isopropanol ingestion. The possible association of isopropanol ingestion and sinovenous thrombosis is discussed...
  14. doi Outcomes of perinatal arterial ischemic stroke and cerebral sinovenous thrombosis
    Meredith R Golomb
    Indiana University School of Medicine, Building XE, Room 040, 575 West Dr, Indianapolis, IN 46202, USA
    Semin Fetal Neonatal Med 14:318-22. 2009
    ..Rehabilitation can ameliorate deficits, and advances in rehabilitation technology and in adult stroke rehabilitation offer promise to pediatric perinatal stroke patients...
  15. doi In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
    Arch Phys Med Rehabil 91:1-8.e1. 2010
    ..Golomb MR, McDonald BC, Warden SJ, Yonkman J, Saykin AJ, Shirley B, Huber M, Rabin B, AbdelBaky M, Nwosu ME, Barkat-Masih M, Burdea GC. In-home virtual reality videogame telerehabilitation in adolescents with hemiplegic cerebral palsy...
  16. doi Grade IV fetal intracranial hemorrhage with good cognitive function
    Erica T Ting
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 42:231-3. 2010
    ..We discuss how perinatal care may have contributed to her good outcome...
  17. ncbi Neonatal arterial ischemic stroke and sinovenous thrombosis associated with meningitis
    Karima C Fitzgerald
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, 575 West Drive, Indianapolis, IN, USA
    J Child Neurol 22:818-22. 2007
    ..7% (4/52) of cases of cerebral sinovenous thrombosis in our perinatal stroke database. Further work is needed to clarify when infarction occurs during meningitis and which children are at highest risk...
  18. ncbi Sickle cell trait is a risk factor for early stroke
    Meredith R Golomb
    Department of Neurology, Riley Hospital, Indiana University School of Medicine, Indianapolis 46202, USA
    Arch Neurol 62:1778-9. 2005
  19. ncbi Family history is a poor screen for prothrombotic genes in children with stroke
    Sheila C Johal
    Department of Medical Genetics, Division of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    J Pediatr 148:68-71. 2006
    ..To evaluate family history of early pathological thrombosis as a screen for genetic prothrombotic risk factors in children with stroke...
  20. ncbi Early stroke and cerebral vasculopathy in children with facial hemangiomas and PHACE association
    Beth A Drolet
    Department of Pediatrics, Medical College of Wisconsin, Children s Hospital of Wisconsin, Milwaukee, Wisconsin, USA
    Pediatrics 117:959-64. 2006
    ....
  21. ncbi Cerebral sinovenous thrombosis in the neonate
    Karima C Fitzgerald
    Division of Pediatric Neurology, University School of Medicine, Indianapolis, IN 46202, USA
    Arch Neurol 63:405-9. 2006
    ..There are few studies on neonatal cerebral sinovenous thrombosis (SVT)...
  22. ncbi Asymptomatic sinovenous thrombosis in a healthy neonate
    Meredith R Golomb
    Indiana University School of Medicine, Indianapolis, IN 46202, USA
    Neurology 66:1186. 2006
  23. ncbi Outcomes of children with infantile spasms after perinatal stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis 46202, USA
    Pediatr Neurol 34:291-5. 2006
    ..However, a subgroup of children with spasms caused by delayed presentation of "presumed perinatal stroke" appears to have better epilepsy and cognitive outcomes...
  24. ncbi Chiari in the family: inheritance of the Chiari I malformation
    Aimee J Szewka
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 34:481-5. 2006
    ..Less common presentations of Chiari malformation type I are discussed, as well as the possible pathogenesis of Chiari malformation type I and associated syringomyelia...
  25. ncbi Perinatal stroke in twins without co-twin demise
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 35:75-7. 2006
    ..Twin gestation without co-twin demise may be a risk factor for perinatal stroke, and might help explain the higher incidence of cerebral palsy in twins...
  26. ncbi Kinky vessels and double joints: useful clues for childhood stroke?
    Meredith R Golomb
    Neurology 67:199-200. 2006
  27. ncbi Accuracy and yield of ICD-9 codes for identifying children with ischemic stroke
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Riley Hospital for Children Room 1757702 Barnhill Drive, Indianapolis, IN 46202, USA
    Neurology 67:2053-5. 2006
    ..Code accuracy ranged from 37 to 88%; each code missed more than half of AIS identified by the combined code search. Studies are needed to determine whether other local and national ICD-9 databases have similar limitations...
  28. ncbi The impact of Pelizaeus-Merzbacher disease on the family
    Lisa M McGuire
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, and the Roudebush Veterans Affairs Medical Center Health Services Research and Development Service, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 36:101-5. 2007
    ....
  29. pmc Ischemic spinal cord infarction in children without vertebral fracture
    Jessica R Nance
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 36:209-16. 2007
    ....
  30. ncbi Accuracy of ICD-9 codes for identifying children with cerebral sinovenous thrombosis
    Meredith R Golomb
    Division of Pediatric Neurology, Indiana University School of Medicine, Indianapolis 46202, USA
    J Child Neurol 22:45-8. 2007
    ..Furthermore, it is important to search for the code in any position as limiting searches to the primary position misses most cases...
  31. ncbi Two cousins with neonatal stroke, PAI-1 4G variant and MTHFR A1298C mutation
    Meredith R Golomb
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Indianapolis 46202, USA
    J Child Neurol 22:753-5. 2007
    ..Her cousin was homozygous for the plasminogen activator inhibitor-1 4G variant and heterozygous for the methylenetetrahydrofolate reductase A1298C and factor V Leiden mutations...
  32. ncbi Carotid dissection and stroke after tonsillectomy and adenoidectomy
    Karen S Carvalho
    Division of Pediatric Neurology, Department of Neurology, Indiana University School of Medicine, Riley Hospital, Indianapolis, Indiana 46202, USA
    Pediatr Neurol 37:127-9. 2007
    ..We discuss the risk factors that may predispose patients to these complications...