Idiopathic Cerebral Infarction and Upper Limb Ischemia in Neonates

Guajardo, Leonel; Strauss, Arthur; Amster, Jay

doi:10.1055/s-2007-994570

Cited by 12 publications

(13 citation statements)

References 3 publications

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“…In the present case, gangrene of the left arm was probably followed by cerebral infarction in the left hemisphere. So far, the combination of intrauterine extremity ischemia and cerebral infarction has only been described in a handful of cases in the literature [9, 11–13]. This rare event should be approached with great care.…”

Section: Discussionmentioning

confidence: 99%

Intrauterine Extremity Gangrene and Cerebral Infarction at Term: A Case Report

Tanvig

Jørgensen

Nybo

et al. 2011

Case Reports in Pediatrics

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Intrauterine extremity gangrene in combination with cerebral infarction is a serious and rare event. We present a case with a healthy mother who gave birth to a child with this condition. At term, the mother presented at the antenatal clinic with decreased fetal movements. Cardiotocography (CTG) showed signs of fetal distress and a caesarean section was performed. The left arm of the newborn was found gangrenous. Amputation of the arm was necessary and the child was subsequently treated with anticoagulant therapy due to thrombosis and cerebral infarction in the left hemisphere found by magnetic resonance imaging (MRI). At one year of age the boy was doing well and had prosthesis as a left arm. He had no signs of further complications. Despite thorough examination of the parents and the child, the reason for the thrombosis is still unknown.

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Section: Discussionmentioning

confidence: 99%

Intrauterine Extremity Gangrene and Cerebral Infarction at Term: A Case Report

Tanvig

Jørgensen

Nybo

et al. 2011

Case Reports in Pediatrics

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“…A review of the literature revealed reports of 8 other children who appeared to have had emboli to both an extremity and the brain during the perinatal period [3][4][5][6][7][8][9] (Table 1). Each of these children presented with limb ischemia within 10 minutes of…”

Section: Discussionmentioning

confidence: 99%

“…2 Some children with perinatal stroke appear normal as neonates but later develop asymmetric use of extremities, seizures, or developmental delay. 2,11 Several of the children with both perinatal limb and brain ischemia had perinatal seizures 4,6 or apneic episodes, 6,9 but several had no clear perinatal signs of stroke. 5,7,8 Several were first diagnosed when screening cranial imaging was performed before starting thrombolytics for limb ischemia 6,8 or to further evaluate carotid occlusions seen on color Doppler sonography.…”

mentioning

confidence: 99%

“…2,11 Several of the children with both perinatal limb and brain ischemia had perinatal seizures 4,6 or apneic episodes, 6,9 but several had no clear perinatal signs of stroke. 5,7,8 Several were first diagnosed when screening cranial imaging was performed before starting thrombolytics for limb ischemia 6,8 or to further evaluate carotid occlusions seen on color Doppler sonography. 5 Cerebral ischemia was not always ipsilateral to limb ischemia; some children had stroke contralateral to limb ischemia, 8,9 bilateral infarcts, 4,6 and/or bilateral limb ischemia.…”

mentioning

confidence: 99%

“…5,7,8 Several were first diagnosed when screening cranial imaging was performed before starting thrombolytics for limb ischemia 6,8 or to further evaluate carotid occlusions seen on color Doppler sonography. 5 Cerebral ischemia was not always ipsilateral to limb ischemia; some children had stroke contralateral to limb ischemia, 8,9 bilateral infarcts, 4,6 and/or bilateral limb ischemia. 6 Only 1 child had an ischemic leg 9 ; this was also the only child with organ involvement (liver ischemia and adrenal hemorrhage).…”

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confidence: 99%

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Two Children With Both Arm Ischemia and Arterial Ischemic Stroke During the Perinatal Period

McKasson

Golomb

2011

J Child Neurol

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It is rare for both limb ischemia and arterial ischemic stroke to occur in the same child during the perinatal period. Two children who appear to have had perinatal emboli to both an arm and a middle cerebral artery territory are presented here. One child required amputation of the ischemic limb below the shoulder, and the other required skin grafts to the distal ischemic fingers. Each of these children later received cerebral magnetic resonance imaging for evaluation of developmental delay and was found to have what appeared to be old perinatal arterial ischemic stroke. Both children were homozygous for the methylenetetrahydrofolate reductase C677T gene variant. Eight other children with perinatal limb ischemia and stroke were found on literature review; several also had delayed diagnosis of perinatal stroke. This report examines the approach to diagnosis and treatment in each of these and makes suggestions for the similar cases in the future.

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