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Cerebral infarction as multifocal clonic seizures in a term neonate
1Department of Family Practice, Naval Hospital Camp Pendleton, Calif., USA.
Insights
Neonatal stroke, though rare, can be missed in newborns. Early diagnosis using imaging like CT and MRI is crucial for identifying causes such as placental thromboemboli and potential long-term developmental issues.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Neonatal stroke incidence is estimated at 1:10,000 in full-term infants.
- The condition often presents with subtle symptoms, leading to potential underdiagnosis.
- Long-term follow-up reveals significant developmental challenges in affected children, including hemiparesis and cognitive difficulties.
Background:
The incidence of neonatal stroke in full-term infants has been cautiously estimated as 1:10,000, but infants can initially have few symptoms, and the condition has the potential for underdiagnosis. Follow-up studies of known full-term neonatal stroke victims beyond 3 years of age indicate that most develop some form of hemiparesis, seizure disorder, cognitive difficulties, or developmental delay during childhood.
Methods:
The case of a full-term infant who had a left middle cerebral artery infarction and who developed multifocal clonic seizures 9 hours after delivery is described and discussed.
Results:
Head sonograms first showed evidence of disease when the infant was 72 hours old. Computed tomography (CT) of the head when the infant was 82 hours old showed an ischemic infarction in the distribution of the left middle cerebral artery. Subsequent magnetic resonance angiography showed a resolving embolus in the left middle cerebral artery.
Conclusions:
Serial sonograms and CT scans of the infant's head, along with magnetic resonance angiography, were useful in making the diagnosis of cerebral infarction. A late intrauterine placental thromboembolus was the most likely cause. Maternal history of a previous cesarean section could be a risk factor. More studies are needed to define the incidence of this disease and to describe the risk factors.