Perinatal Stroke

Question 1

What does it result from?

Answer 1

Cerebral vascular injury in fetus or neonate

Question 2

What is the commonest cause?

Answer 2

Ischaemia of the middle cerebral artery

Other causes: haemorrhage or venous thrombosis in the dural venous sinuses

Question 3

In a term infant, how do they present?

Answer 3

With seizures at 12-48 hours
The seizure may be focal or generalised
Also: lethargy, hypotonia, apnoea, hemiparesis

Question 4

How is the diagnosis confirmed?

Answer 4

By MRI

Question 5

What is the mechanism of perinatal arterial ischaemic strokes?

Answer 5

Thrombotic - either thromboembolism from placental vessels or can be secondary to inherited thrombophilia

Question 6

What can large lesions result in?

Answer 6

Epilepsy

Question 7

Nearly 50% develop what?

Answer 7

Motor disability - usually a hemiplegia of the contralateral side presenting in infancy or childhood
And some cognitive dysfunction

Question 8

What condition can it result in?

Answer 8

CP