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TitlePerinatal stroke: a six-year experience in a level-III maternity
Author(s)Teixeira, Joana
Sá, Carla
Antunes, Henedina
Costa, Sandra
Barbosa, Célia
Fernandes, João
Pereira, Almerinda
KeywordsBrain MRI
Cerebral venous thrombosis
Perinatal stroke
Brain MR1
Issue date1-Jan-2017
PublisherHygeia Press di Corridori Marinella
JournalJournal of Pediatric and Neonatal Individualized Medicine
CitationTeixeira, J., Sá, C., Antunes, H., Costa, S., Barbosa, C., Fernandes, J., & Pereira, A. (2017). Perinatal stroke: a six-year experience in a level-III maternity. Journal of Pediatric and Neonatal Individualized Medicine (JPNIM), 6(2), e060220
Abstract(s)Aims: To study the incidence of perinatal stroke in a level-Ill maternity as well as potential risk factors, clinical presentation, neuroimagirw, classification and clinical outcome of children with a minimum follow-up of 24 months. Methods: Historical prospective follow-up of all term and late preterm newborns diagnosed with perinatal stroke from.lanuary 2008 to December 2013. Results: Fifteen perinatal strokes were diagnosed in a total of 17,056 newborns (incidence 0.9/1,000). Thirteen had potential risk factors and fourteen were symptomatic. Median age at diagnosis was two days. Seizures were the most frequent symptom (14/15), being three focal-clonic, one multifocalclonic, two generalized-tonic, three focal-tonic and five subtle. Cerebral ultrasound was performed in eleven newborns at an early stage, suggesting the diagnosis in six. Cerebral magnetic resonance imaging (MR1) confirmed the diagnosis in fifteen. Six had an arterial ischemic stroke, eight a cerebral venous thrombosis and one a hemorrhagic stroke. An electroencephalogram was obtained in all newborns with seizures revealing epileptic activity in eight. Search for prothrombotic disorders (in newborn and both parents) showed four newborns heterozygous methylene tetrahydrofolate reductase mutation and two neonatal alloimune thrombocytopenia. No recurrence of stroke was reported. Formal development evaluation was perlbrmed in thirteen and was normal in eleven, while in two revealed delayed psychomotor development, both of which with epilepsy. On the neonatology outpatient clinic follow-up, the current median age is 3 years and 11 months. Conclusions: This study reinforces the need to maintain high level of suspicion for perinatal stroke and the importance of MRI in the classification and etiological study. Our follow-up supported a good outcome of perinatal stroke.
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AccessOpen access
Appears in Collections:ICVS - Artigos em Revistas Internacionais com Referee

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