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Perinatal cerebral infarction
Insights
Perinatal cerebral infarction, or infant stroke, is often diagnosed postmortem. This study found perinatal asphyxia to be a common cause, with most affected infants experiencing poor outcomes.
Area of Science:
- Neonatal Neurology
- Pediatric Stroke
- Perinatal Medicine
Background:
- Perinatal cerebral infarction diagnosis is challenging, often confirmed postmortem.
- Few studies report on infant survival after perinatal stroke.
- Neonatal seizures are a common clinical sign.
Purpose of the Study:
- To evaluate the incidence and outcomes of perinatal cerebral infarction in infants.
- To identify common causes and clinical presentations of infant stroke.
- To assess the short-term prognosis for infants diagnosed with perinatal cerebral infarction.
Main Methods:
- Retrospective review of 18 infants diagnosed with perinatal cerebral infarction over a 12-month period.
- Analysis of clinical data, including gestational age, associated conditions (e.g., intraventricular hemorrhage), and stroke etiology.
- Correlation of computed tomographic (CT) scan findings with clinical presentation and outcomes.
Main Results:
- Eighteen infants with perinatal cerebral infarction were identified.
- Perinatal asphyxia was the most frequent cause identified.
- Seven infants were preterm, and 11 were term neonates.
- Fourteen infants presented with neonatal seizures.
- Poor outcomes (death or significant disability) were observed in 14 of 18 infants by 4-12 months corrected age.
Conclusions:
- Perinatal cerebral infarction is a significant cause of morbidity and mortality in neonates.
- Perinatal asphyxia is a primary risk factor for infant stroke.
- Early diagnosis and intervention are crucial, though outcomes remain poor for many affected infants.
Abstract:
The diagnosis of perinatal cerebral infarction, although frequently suggested clinically, has been made most commonly at postmortem examination; few infants surviving stroke are reported in the literature. We evaluated 18 infants with perinatal cerebral infarction in a recent twelve-month interval. Seven were preterm neonates, 6 of whom had experienced neonatal intraventricular hemorrhage. Three full-term infants were thought to have experienced cerebral infarction in utero and had evidence of well-defined strokes on computed tomographic scans performed shortly after birth. Eight infants developed stroke at term. The most common cause of cerebral infarction in our series was perinatal asphyxia. Fourteen of the infants were seen with neonatal seizures. Fourteen of the 18 have died or are faring poorly at 4 to 12 months of age (corrected).