Risk factors, clinical presentation, and neuroimaging findings of neonatal perforator stroke.

Abstract:

BACKGROUND AND PURPOSE:To date, studies on neonatal stroke have mainly focused on cortical stroke. We have focused on perforator strokes, noncortical strokes in the arterial vascular perforator area. We sought to identify risk factors and evaluate clinical presentation and neuroimaging findings for neonatal perforator stroke, which seems to be under-recognized. METHODS:All infants admitted to our tertiary intensive care unit in ≈12 years, whose perforator stroke was diagnosed with postnatal brain imaging, were enrolled in this study. Demographic, perinatal, and postnatal data were evaluated. RESULTS:Seventy-nine perforator strokes were detected in 55 patients (28 boys), with a median gestational age of 37 1/7 weeks (range 24 1/7 to 42 1/7 weeks, 25 preterm). Perforator stroke was asymptomatic in most patients (58%). Initial diagnosis was predominantly made with cranial ultrasound (80%) in the first week of life (60%). Risk factors for stroke were present in all cases: maternal, fetal, and perinatal. Likely pathogenic mechanisms were prolonged birth asphyxia (16%), hypoxia or hypotension (15%), embolism (15%), infection (15%), acute blood loss (9%), and birth trauma (9%). CONCLUSIONS:Previously described risk factors for developing neonatal main artery stroke are probably also associated with neonatal perforator stroke. Perforator stroke is often asymptomatic, but cranial ultrasound is a reliable diagnostic tool in diagnosing perforator stroke.

journal_name

Stroke

journal_title

Stroke

authors

Ecury-Goossen GM,Raets MM,Lequin M,Feijen-Roon M,Govaert P,Dudink J

doi

10.1161/STROKEAHA.113.001064

subject

Has Abstract

pub_date

2013-08-01 00:00:00

pages

2115-20

issue

8

eissn

0039-2499

issn

1524-4628

pii

STROKEAHA.113.001064

journal_volume

44

pub_type

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