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Outcome of neonatal stroke in full-term infants without significant birth asphyxia
1Department of Paediatrics (Neurology), King Abdulaziz University and the College of Medicine and Allied Health Sciences, Jeddah, Saudi Arabia.
Insights
Neonatal stroke in full-term infants without birth asphyxia typically results in a favorable neurological outcome. Seizures are usually confined to the first three days of life, suggesting short-term anticonvulsant treatment is effective.
Area of Science:
- Neonatal neurology
- Pediatric stroke research
- Neurodevelopmental outcomes
Background:
- Neonatal stroke is a significant cause of neurological impairment in newborns.
- Understanding the specific outcomes for term infants without birth asphyxia is crucial for targeted interventions.
Purpose of the Study:
- To evaluate the neurological outcomes of full-term infants diagnosed with neonatal stroke.
- To characterize seizure patterns and treatment responses in this specific population.
Main Methods:
- Retrospective follow-up of six term infants with neonatal stroke over a mean of 28 months.
- Analysis of seizure presentation, neuroimaging (CT scans), and developmental assessments.
- Evaluation of anticonvulsant treatment duration and efficacy.
Main Results:
- Six of seven infants had ischemic infarcts; one had a hemorrhagic infarct.
- Seizures, primarily focal clonic, occurred within the first 48 hours and resolved by day 3 in all cases.
- All infants demonstrated normal development with no significant neurological deficits at follow-up.
Conclusions:
- Neonatal stroke in term infants, when unrelated to significant birth asphyxia, is associated with a positive neurological prognosis.
- Seizure activity is typically transient, limited to the initial days of life.
- Short-term anticonvulsant therapy appears sufficient for managing seizures in these cases.
Unlabelled:
Seven children with neonatal stroke were identified and six were followed for 13 months to 5 years (mean 28 months). Gestational age ranged between 39 and 42 weeks and none had hypoxic ischaemic encephalopathy. Focal clonic seizures were the presenting feature in six, and one presented with apnoea. The age of the first seizure ranged between 8 and 48 h (mean 26). The total number of seizures ranged between 3 and 10 (mean 5), and all seizures resolved by day 3 in all cases. CT scan showed an ischaemic infarct in six cases, and one child had a haemorrhagic infarct in the right anterior cerebral artery distribution. Phenobarbital was maintained for 3 weeks to 6 months (mean 11 weeks). None had recurrent seizures beyond the 3rd day of life and all were developing normally with no significant focal neurological deficits on follow up assessment.
Conclusions:
Full-term infants with neonatal stroke unrelated to significant birth asphyxia have a favourable neurological outcome. Seizures appear to be restricted to the first 3 days of life. We recommend short-term treatment with anticonvulsants.
Related Concept Videos
01:29Stroke: Introduction and Types
01:15Ischemic Stroke l: Introduction
01:15Ischemic Stroke ll: Pathophysiology