An exploratory study to identify neonatal arterial ischemic stroke: A single-center study.

Area of Science:

• Neonatology
• Neurology
• Pediatric Stroke

Background:

• Neonatal arterial ischemic stroke (NAIS) often leads to long-term neurological issues.
• Diagnosis of NAIS is frequently delayed due to low test sensitivity.
• Identifying early clinical diagnostic factors for NAIS in neonates with seizures is critical.

Purpose of the Study:

• To identify early clinical diagnostic factors for neonatal arterial ischemic stroke (NAIS) in neonates presenting with seizures.
• To investigate the association between maternal conditions and NAIS.
• To evaluate the utility of transcranial Doppler sonography in NAIS diagnosis.

Main Methods:

• Retrospective review of 54 neonates with seizures who underwent brain MRI.
• Analysis of maternal background, clinical characteristics, and transcranial pulsed Doppler sonography (TCDS) findings.
• Comparison of TCDS parameters (MCA resistance index, mean flow velocity) between NAIS and non-NAIS groups.

Main Results:

• Maternal premature ventricular contraction (PVC) complications were significantly higher in the NAIS group.
• Neonates with NAIS showed a lower mean middle cerebral artery (MCA) resistance index (RI).
• Higher mean MCA blood velocity (MnV) and left-right differences in RI and MnV were observed in the NAIS group.

Conclusions:

• Maternal arrhythmia, specifically PVCs, may serve as a potential diagnostic factor for NAIS.
• Early brain MRI is essential for neonates with seizures.
• Specific cerebral blood flow velocity patterns (low MCA-RI, high MCA-MnV, high inter-hemispheric differences) can help distinguish NAIS from non-NAIS.