Fetal stroke and cerebrovascular disease

Severe fetal intracranial hemorrhage: Congenital Cytomegalovirus infection may play a role? A case report and review of literature

“…This type of complication has been reported mostly in extremely premature infants [ 10 ] and less frequently in term neonates. As differential diagnosis, fetal stroke has been reported also in association with thrombocytopenia, prothrombotic disorders, bleeding diathesis, metabolic diseases, maternal trauma and use of warfarin, anticonvulsant and cocaine [ [11] , [12] , [13] ] that were excluded in our patient. ICH has also been reported in fetuses proven to have COL4A1 mutations but the absence of positive familiar anamnesis for stroke and the normality of eye exam led us to exclude it [ 13 ].…”

Magnetic resonance imaging reconstruction algorithm under complex convolutional neural network in diagnosis and prognosis of cerebral infarction

“…The distributions of cerebral veins in the brain hemispheres in the affected and health side on the MRI image were compared, and it could be defined as abnormality if the number of veins was increased or the vessel wall was thickened [ 9 ]. Cerebral venous abnormalities mainly included: grade 0 (no visible changes in the two measured cerebral veins), grade 1 (the cerebral vein of the diseased side was slightly increased or thicker than the healthy side); and grade 2 (the cerebral vein on the affected side was obviously increased and thicker than that on the healthy side) [ 10 ].…”

Hypoxia: A teratogen underlying a range of congenital disruptions, dysplasias, and malformations

“…Strokes fall into two broad categories, hemorrhagic and nonhemorrhagic (ischemic) strokes (Ferrer & Vidal, 2018). Hemorrhagic strokes are characterized by a blood vessel rupture or leak in the brain parenchyma, the periventricular area, intraventricularly, or in other spaces (Ferrer & Vidal, 2018;Kirkham et al, 2018). A hemorrhagic stroke involving brain parenchyma typically causes a void of brain tissue around the rupture or leakage in which the brain tissue cannot maintain conditions for survival.…”

“…Typical congenital brain abnormalities caused by disruption of blood flow (ischemia) include the well-recognized findings of encephalomalacia, schizencephaly, and/or cyst formation, such as porencephaly discussed above (Kirkham et al, 2018). However, there is also evidence that fetal brain ischemia later in gestation can cause more classically recognized patterns of abnormal embryonic neuronal migration such as polymicrogyria, focal cortical dysgenesis, and low grade focal cortical dysplasia (Diamandis et al, 2017;Durrani-Kolarik et al, 2017;Kirkham et al, 2018;Krsek et al, 2010). This is not surprising given that incomplete or focal cortical dysplasia has been proposed to be on the mildest end of the schizencephaly spectrum (Fernandez-Bouzas et al, 2006).…”

“…These included malformations of cortical development such as polymicrogyria, periventricular nodular heterotopia, and absent septum pellucidum. Proposed mechanisms for the fetal vascular perfusion defects included fetal hypotension from hemorrhaging into a demised co-twin or the placenta, which also can cause concurrent severe fetal anemia or twin-twin transfusion from fetal vascular anastomoses (Kirkham et al, 2018). Interestingly, a case of chronic placental abruption led to the birth of a term male who was identified to have bilateral perisylvian polymicrogyria, thickened and dysplastic cortex characterized by shallow sulci and broad gyri, and limb defects consisting of hypoplasia and syndactyly of fingers 2 through 4 (with the third finger most severely affected) and hypoplasia of the left great toe (Yamanouchi et al, 2002).…”