Neonatal posterior cerebral artery stroke: clinical presentation, MRI findings, and outcome

Abstract

DWI Diffusion-weighted imaging MCA Middle cerebral artery PAIS Perinatal arterial ischemic stroke PCA Posterior cerebral artery AIM To report the clinical presentation, magnetic resonance imaging (MRI) findings, and follow-up data of newborn infants with perinatal arterial ischemic stroke in the territory of the posterior cerebral artery (PCA).METHOD Data on 18 newborn infants from three neonatal intensive care units (11 males, seven females) with an MRI-confirmed PCA stroke were analysed and reported. Infants were born at a mean gestational age of 38.7 weeks (SD 3.4) with a mean birthweight of 3244g (SD 850).RESULTS Fourteen infants presented with clinical seizures. Five of these had associated hypoxic-ischemic encephalopathy, four had hypoglycaemia, and five had neither hypoxicischemic encephalopathy nor hypoglycaemia. Subclinical seizures were present in one infant with hypoxic-ischemic encephalopathy and one with meningitis. One preterm infant presented with apnoeas and one had hypoxic-ischemic encephalopathy without seizures. Neurodevelopmental follow-up of 17 children at a median age of 36 months (SD 28, range 12-120mo) showed five with a global delay. Two children with additional injury developed postneonatal epilepsy and one child with extensive injury developed hemiplegia. A visual field defect was observed in nine children (six hemianopia, three quadrantanopia). In the 11 children with a second MRI at 3 months, the asymmetry of the optic radiation correlated with the development of a visual field deficit.

Early EEG biomarkers of perinatal arterial ischemic stroke:a case series

“…An international child stroke study found that neonatal cerebral infarction preferentially involved the middle cerebral artery and left hemisphere, with bilateral lesions accounting for only 24% of cases [11] . In this study, 16 cases (76.19%) involved the left middle cerebral artery, only one case (6.67%) involved the posterior cerebral artery, and no cases involved the anterior cerebral artery, similar to previous studies [12-13] .…”

Early EEG biomarkers of perinatal arterial ischemic stroke:a case series

“…An international child stroke study found that neonatal cerebral infarction preferentially involved the middle cerebral artery and left hemisphere, with bilateral lesions accounting for only 24% of cases [11] . In this study, 16 cases (76.19%) involved the left middle cerebral artery, only one case (6.67%) involved the posterior cerebral artery, and no cases involved the anterior cerebral artery, similar to previous studies [12-13] .…”

Childhood Stroke and Vision: A Review of the Literature

“…In studies drawing subjects from the same longitudinal study [1][2][3], only the most recent data were reported. In studies using the same data [4][5][6], only the most recent and largest studies were reported. (Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included.…”

“…(Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included. Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9].…”

“…Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9]. Total number of patients displaying visual field defects could not be reported because visual field data for each patient were not described in one study [8].…”

Neonatal cerebral infarction: A case report

“…The etiology of NCI is complex, and the risk factors and prognostic factors remain unclear. [ 3 ] It may be due to a combination of various high-risk factors. Studies have shown that the probability of NCI occurring after cesarean delivery is 3 to 4 times higher than that after natural delivery, and cesarean surgery itself is a high-risk factor for thrombosis, indicating that cesarean delivery is a risk factor for cerebral infarction.…”

Early EEG biomarkers of perinatal arterial ischemic stroke:a case series

“…An international child stroke study found that neonatal cerebral infarction preferentially involved the middle cerebral artery and left hemisphere, with bilateral lesions accounting for only 24% of cases [11] . In this study, 16 cases (76.19%) involved the left middle cerebral artery, only one case (6.67%) involved the posterior cerebral artery, and no cases involved the anterior cerebral artery, similar to previous studies [12-13] .…”

Childhood Stroke and Vision: A Review of the Literature

“…In studies drawing subjects from the same longitudinal study [1][2][3], only the most recent data were reported. In studies using the same data [4][5][6], only the most recent and largest studies were reported. (Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included.…”

“…(Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included. Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9].…”

“…Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9]. Total number of patients displaying visual field defects could not be reported because visual field data for each patient were not described in one study [8].…”

Neonatal cerebral infarction: A case report

“…The etiology of NCI is complex, and the risk factors and prognostic factors remain unclear. [ 3 ] It may be due to a combination of various high-risk factors. Studies have shown that the probability of NCI occurring after cesarean delivery is 3 to 4 times higher than that after natural delivery, and cesarean surgery itself is a high-risk factor for thrombosis, indicating that cesarean delivery is a risk factor for cerebral infarction.…”

Early EEG biomarkers of perinatal arterial ischemic stroke:a case series

“…An international child stroke study found that neonatal cerebral infarction preferentially involved the middle cerebral artery and left hemisphere, with bilateral lesions accounting for only 24% of cases [11] . In this study, 16 cases (76.19%) involved the left middle cerebral artery, only one case (6.67%) involved the posterior cerebral artery, and no cases involved the anterior cerebral artery, similar to previous studies [12-13] .…”

Childhood Stroke and Vision: A Review of the Literature

“…In studies drawing subjects from the same longitudinal study [1][2][3], only the most recent data were reported. In studies using the same data [4][5][6], only the most recent and largest studies were reported. (Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included.…”

“…(Table 1) There are a wide range of visual abnormalities seen in perinatal stroke survivors (Table 1); 136 children were included. Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9].…”

“…Three of the identified studies were longitudinal cohort studies, and only the most recent data were reported [1,4,6]. Overall, visual field defects were the most common deficit [1,4,[6][7][8][9]. Total number of patients displaying visual field defects could not be reported because visual field data for each patient were not described in one study [8].…”

Neonatal cerebral infarction: A case report

“…The etiology of NCI is complex, and the risk factors and prognostic factors remain unclear. [ 3 ] It may be due to a combination of various high-risk factors. Studies have shown that the probability of NCI occurring after cesarean delivery is 3 to 4 times higher than that after natural delivery, and cesarean surgery itself is a high-risk factor for thrombosis, indicating that cesarean delivery is a risk factor for cerebral infarction.…”