Perinatal Stroke ✅ Flashcards
What is the incidence of perinatal stroke?
0.2-1 per 1000 live births
What are the types of neonatal stroke?
- Perinatal arterial ischaemic stroke (PAIS)
- Haemorrhage
- Cerebral sinovenous thrombosis (CSVT)
What is the most common site of perinatal arterial ischaemic stroke?
Left middle cerebral artery
What are the types of perinatal haemorrhagic stroke?
- Parenchymal
- Subarachnoid
- Intraventricular
What can CVST lead to?
Venous infarction, often with haemorrhage
What does PAIS typically result from?
Thromboembolism
Where can thromboembolism causing PAIS originate from?
- Placental vessels
- Venous thromboembolism crossing a PFO
- Right-to-left shunts in congenital heart disease
- Thrombi from umbilical vessel catheters
What factors may contribute to the development of thromboembolism causing PAIS?
- Sepsis
- Meningitis
- Trauma
- Prothrombotic disorders
Give 2 examples of prothrombotic disorders that may contribute to PAIS
- Protein C deficiency
- Protein S deficiency
What can neonatal haemorrhagic stroke result from?
- Intraparenchymal haemorrhage from vascular anomalies
- Haemorrhage into ischaemic infarction
What is periventricular haemorrhagic infarction associated with?
Intra-ventricular haemorrhage in extremely premature infants
How does perinatal stroke classically present?
Focal seizures in the first 3 days of life
Is perinatal stroke always clinically apparent?
No, may be asymptomatic
What investigations may be performed in perinatal stroke?
- Cranial ultrasound
- MRI
- Investigations to rule out underlying disorders
What is the importance of MRI in perinatal stroke?
Required for accurate diagnosis and prognosis
