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Updated: Aug 12, 2026

Transient Middle Cerebral Artery Occlusion Model of Neonatal Stroke in P10 Rats
Published on: April 21, 2017
Intrapartum, atraumatic, non-asphyxial intracranial hemorrhage in a full-term infant
H Asakura1, B S Schifrin, S A Myers
1Department of Obstetrics and Gynecology, Mount Sinai Hospital Medical Center of Chicago, Illinois, USA.
Background:
Intracranial hemorrhage in a full-term infant is uncommon, is usually subarachnoid in type, and is usually associated with operative vaginal delivery or asphyxia.
Case:
A 15-year-old primigravid woman at 37 weeks' gestation developed a prolonged second stage of labor associated with persistent occiput posterior position. With the onset of pushing, baseline fetal heart rate (FHR) decreased and variability increased. Thirty minutes before vaginal delivery, sudden fetal tachycardia (up to 210 beats per minute) was observed, with absent variability and minimal decelerations. At birth, the infant was apneic and hypotonic, but lacked biochemical evidence of acidemia or asphyxia; seizures developed in the early neonatal period. Subarachnoid hemorrhage was demonstrated by computed tomography of the head.
Conclusion:
The occiput posterior position, marked molding, and prolonged labor with compulsive pushing may be associated with an increased risk of adverse outcome, even unrelated to the details of delivery. The change in FHR pattern, to a lowered baseline rate and increased variability, suggests increased intracranial pressure. The sudden change to fetal tachycardia with absent variability before delivery suggests intracranial hemorrhage or injury.
Related Concept Videos
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Transient Ischemic Attack l: Introduction
Traumatic Brain Injury l: Introduction
Increased Intracranial Pressure l: Introduction
Increased Intracranial Pressure ll: Pathophysiology

