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TAS Neonatal Medicine ✅ > Perinatal Stroke ✅ > Flashcards

Perinatal Stroke ✅ Flashcards

1
Q

What is the incidence of perinatal stroke?

A

0.2-1 per 1000 live births

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2
Q

What are the types of neonatal stroke?

A
  • Perinatal arterial ischaemic stroke (PAIS)
  • Haemorrhage
  • Cerebral sinovenous thrombosis (CSVT)
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3
Q

What is the most common site of perinatal arterial ischaemic stroke?

A

Left middle cerebral artery

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4
Q

What are the types of perinatal haemorrhagic stroke?

A
  • Parenchymal
  • Subarachnoid
  • Intraventricular
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5
Q

What can CVST lead to?

A

Venous infarction, often with haemorrhage

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6
Q

What does PAIS typically result from?

A

Thromboembolism

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7
Q

Where can thromboembolism causing PAIS originate from?

A
  • Placental vessels
  • Venous thromboembolism crossing a PFO
  • Right-to-left shunts in congenital heart disease
  • Thrombi from umbilical vessel catheters
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8
Q

What factors may contribute to the development of thromboembolism causing PAIS?

A
  • Sepsis
  • Meningitis
  • Trauma
  • Prothrombotic disorders
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9
Q

Give 2 examples of prothrombotic disorders that may contribute to PAIS

A
  • Protein C deficiency

- Protein S deficiency

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10
Q

What can neonatal haemorrhagic stroke result from?

A
  • Intraparenchymal haemorrhage from vascular anomalies

- Haemorrhage into ischaemic infarction

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11
Q

What is periventricular haemorrhagic infarction associated with?

A

Intra-ventricular haemorrhage in extremely premature infants

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12
Q

How does perinatal stroke classically present?

A

Focal seizures in the first 3 days of life

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13
Q

Is perinatal stroke always clinically apparent?

A

No, may be asymptomatic

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14
Q

What investigations may be performed in perinatal stroke?

A
  • Cranial ultrasound
  • MRI
  • Investigations to rule out underlying disorders
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15
Q

What is the importance of MRI in perinatal stroke?

A

Required for accurate diagnosis and prognosis

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16
Q

What investigations to rule out underlying disorders may be done in perinatal stroke?

A
  • Testing for protein C deficiency
  • Testing for protein S deficiency
  • Testing for Factor V Leiden
  • Testing for MTFHR mutation
17
Q

What % of infants with perinatal stroke develop motor disability and cognitive dysfunction?

A

Nearly 50%

18
Q

What is the most common motor disability developed from perinatal stroke?

A

Hemiplegia on the contralateral side

19
Q

When does motor deficiency caused by perinatal stroke present?

A

Infancy or childhood

20
Q

What location of perinatal stroke may be associated with visual impairment?

A

Occipital lesions

21
Q

What might large lesions caused by perinatal stroke lead to?

TAS Neonatal Medicine ✅ (35 decks)

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