Introduction: Perinatal arterial ischaemic stroke (PAIS) is an important cause of morbidity and mortality. The pathophysiology and associated risk factors are no completely understood.

Objective:  Describe the clinical presentations of PAIS and to evaluate associated risk factors.

Materials y methods: Case-control study. We evaluated clinical data of patients with PAIS controlled in our center beetween 1993 and 2012. Each infant with PAIS was matched to three healthy control. Risk factors were studied using univariate and multivariate conditional logistic regression analysis.

Results: We analyzed 40 patients (66,7% male, 33,3% female). The mean gestational age was 39weeks. 21(52,5%) of cases were confirmed as perinatal arterial ischaemic stroke(PAIS) and 19(47,5%) presumed perinatal arterial ischaemic stroke(PPAIS), the mean age of diagosis were 6 days and 2 years-3month, respectivly. The most frequent clinical presentation were seizures(86%) for PAIS and focal neurologic signs(95%) for PPAIS. Strokes preferentially involved the MCA territory(88%), 95% unilateral, 65% in the left hemisphere. All patients presented some neurologic deficit in the folllowing clinical controls, the most common were hemiparesis and epilepsy. Significant risk factors in the multivariate analysis (p<0.05) were nulliparity (OR 11.74; CI 3.28-42.02), emergency caesarean section (OR 13.79; CI 3.51-54.13) and Apgar score (5 min) ≤7 (OR 13.75; CI 1.03-364.03).

Conclusions: The principal clinical profile were seizures in PAIS and focal neurological signs in PPAIS. The prognosis was in general poor, all patients presented neurologic alterations. The risk factors nulliparity, emergency caesarean section, and Apgar score (5 min) ≤7 were found to be important risk factors in PAIS.