Skip to main content
SpringerLink
Log in

Neonatal Arterial Stroke

  • Chapter
Neonatology

Abstract

The term neonatal arterial stroke is used to define focal ischemic brain injuries occurring in the distribution of the territory of one (or more) cerebral arteries. Recently the term perinatal arterial ischemic stroke (PAIS) has been coined to define a group of heterogeneous conditions in which focal disruption of cerebral blood flow occurred between 20 weeks of fetal life through the 28th postnatal day [1] and confirmed by neuroimaging or neuropathological studies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Reference

  1. Raju TN, Nelson KB, Ferriero D et al (2007) Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics 120: 609–616

    Article  PubMed  Google Scholar 

  2. Barmada MA, Moossy J, Shuman RM (1979) Cerebral infarcts with arterial occlusion in neonates. Ann Neurol 6: 495–502

    Article  PubMed  CAS  Google Scholar 

  3. Larroche JC (1977) Occlusion of the cerebral arteries. In: Developmental Pathology of the Neonate. Excerpta Medica, Amsterdam, pp 135–161

    Google Scholar 

  4. Tekgul H, Gauvreau K, Soul J et al (2006) The current etiologic profile and neurodevelopmental outcome of seizures in term newborn infants. Pediatrics 117: 1270–1280

    Article  PubMed  Google Scholar 

  5. Nelson KB (2007) Perinatal ischaemic stroke. Stroke 38: 742–745

    Article  PubMed  Google Scholar 

  6. Benders MJ, Groenendaal F, Uiterwaal CS, de Vries LS (2008) Perinatal arterial stroke in the preterm infant. Semin Perinatol 32: 344–349

    Article  PubMed  Google Scholar 

  7. Benders MJNL, Groenendaal F, de Vries LS (2009) Preterm arterial ischemic stroke. Semin Fetal Neonatal Med 14: 272–277

    Article  PubMed  CAS  Google Scholar 

  8. Lynch JK (2009) Epidemiology and classification of perinatal stroke. Semin Fetal Neonatal Med 14: 245–249

    Article  PubMed  Google Scholar 

  9. Govaert P, Ramenghi L, Taal R et al (2009) Diagnosis of perinatal stroke I: definitions, differential diagnosis and registration. Acta Paediatr 98: 1556–1567

    Article  PubMed  CAS  Google Scholar 

  10. de Vries LS, Groenendaal F, Eken P et al (1997) Infarctions in the vascular distribution of the middle cerebral artery in preterm and full term infants. Neuropaediatrics 28: 88–96

    Article  Google Scholar 

  11. de Vries LS, Eken P, Beek E et al (1996) The posterior fontanelle: a neglected acoustic window. Neuropediatrics 27: 101–104

    Article  PubMed  Google Scholar 

  12. Govaert P, Matthys E, Zecic A et al (2000) Perinatal cortical infarction within the middle cerebral artery trunks. Arch Dis Child Neonatal Ed 82: F59–F63

    Article  CAS  Google Scholar 

  13. Ramaswamy V, Miller SP, Barkovich AJ et al (2004) Perinatal stroke in term infants with neonatal encephalopathy. Neurology 62: 2088–2091

    PubMed  CAS  Google Scholar 

  14. Golomb MR (2009) Outcomes of perinatal arterial ischemic stroke and cerebral sinovenous thrombosis. Semin Fetal Neonatal Med 14: 318–322

    Article  PubMed  Google Scholar 

  15. Cheong JL, Cowan FM (2009) Neonatal arterial ischaemic stroke: obstetric issues. Semin Fetal Neonatal Med 14: 267–271

    Article  PubMed  Google Scholar 

  16. Wu YW, March WM, Croen LA et al (2004) Perinatal stroke in children with motor impairment: a population-based study. Pediatrics 114: 612–619

    Article  PubMed  Google Scholar 

  17. Lee J, Croen LA, Backstrand KH et al (2005) Maternal and infant characteristics associated with perinatal arterial stroke in the infant. JAMA 293: 723–729

    Article  PubMed  CAS  Google Scholar 

  18. Benders MJ, Groenendaal F, Uiterwaal CS et al (2007) Maternal and infant characteristics associated with perinatal arterial stroke in the preterm infant. Stroke 38: 1759–1765

    Article  PubMed  Google Scholar 

  19. Mercuri E, Rutherford M, Cowan F et al (1999) Early prognostic indicators in infants with neonatal cerebral infarction: a clinical, EEG and MRI study. Pediatrics 103: 39–46

    Google Scholar 

  20. Günther G, Junker R, Strater R et al (2000) Symptomatic ischemic stroke in full-term neonates. Stroke 31: 2437–2441

    Article  PubMed  Google Scholar 

  21. Thorarenson O, Ryan S, Hunter J, Younkin DP (1997) Factor V Leiden mutation: an unrecognised cause of hemiplegic cerebral palsy, neonatal stroke and placental haemorrhage. Ann Neurol 42: 372–375

    Article  Google Scholar 

  22. Debus O, Koch HG, Kurlemann G et al (1998) Factor V Leiden and genetic defects of thrombophilia in childhood porencephaly. Arch Dis Child 78: F121–F124

    CAS  Google Scholar 

  23. Mercuri E, Cowan F, Gupte G et al (2001) Prothrombotic disorders and abnormal neurodevelopmental outcome in infants with neonatal cerebral infarction. Pediatrics 107: 1400–1404

    Article  PubMed  CAS  Google Scholar 

  24. Golomb MR, MacGregor DL, Domi T et al (2001) Presumed preor perinatal arterial ischemic stroke: risk factors and outcomes. Ann Neurol 50: 163–168

    Article  PubMed  CAS  Google Scholar 

  25. Lynch JK, Nelson KB, Curry CJ, Grether JK (2001) Cerebrovascular disorders in children with the factor V leiden mutation. J Child Neurol 16: 735–744

    Article  PubMed  CAS  Google Scholar 

  26. Niemann G, Döbler-Neumann M, Scheel P (1999) Warum erleiden schon Neugeborene einen “Schlaganfall”. Klin Pädiatr 211: 154–160

    Article  PubMed  CAS  Google Scholar 

  27. Lynch JK, Han CJ, Nee LE, Nelson KB (2005) Prothrombotic factors in children with stroke or porencephaly. Pediatrics 116: 447–453

    Article  PubMed  Google Scholar 

  28. Ozduman K, Pober BR, Barnes P et al (2004) Fetal stroke. Pediatr Neurol 30: 151–162

    Google Scholar 

  29. Cnossen MH, van Ommen CH, Appel IM (2009) Etiology and treatment of perinatal stroke; a role for prothrombotic coagulation factors? Semin Fetal Neonatal Med 14: 311–317

    Article  PubMed  CAS  Google Scholar 

  30. Hogeveen M, Blom HJ, Van Amerongen M et al (2002) Hyperhomocysteinemia as risk factor for ischemic and hemorrhagic stroke in newborn infants. J Pediatr 141: 429–431

    Article  PubMed  Google Scholar 

  31. Miller SP, Wu YW, Lee J et al (2006) Candidate gene polymorphisms do not differ between newborns with stroke and normal controls. Stroke 37: 2678–2683

    Article  PubMed  Google Scholar 

  32. Ådén U (2009) Neonatal stroke is not a harmless condition. Stroke 40: 1948–1949

    Article  PubMed  Google Scholar 

  33. Amit M, Camfield PR (1980) Neonatal polycythemia causing multiple cerebral infarct. Arch Neurol 37: 109–110

    Article  PubMed  CAS  Google Scholar 

  34. McQuillen PS, Hamrick SE, Perez MJ et al (2006) Balloon atrial septostomy is associated with preoperative stroke in neonates with transposition of the great arteries. Circulation 113: 280–285

    Article  PubMed  Google Scholar 

  35. Parker MJ, Joubert GI, Levin SD (2002) Portal vein thrombosis causing neonatal cerebral infarction. Arch Dis Child Fetal Neonatal Ed 87: F125–F127

    Article  PubMed  CAS  Google Scholar 

  36. Filippi L, Palermo L, Pezzati M et al (2004) Paradoxical embolism in a preterm infant. Dev Med Child Neurol 46: 713–716

    Article  PubMed  Google Scholar 

  37. Christensen DD, Vincent RN, Campbell RM (2005) Presentation of atrial septal defect in the pediatric population. Pediatr Cardiol 26: 812–814

    Article  PubMed  CAS  Google Scholar 

  38. Kraus FT, Acheen VI (1999) Fetal thrombotic vasculopathy in the placenta: cerebral thrombi and infarcts, coagulopathies, and cerebral palsy. Hum Pathol 30: 759–769

    Article  PubMed  CAS  Google Scholar 

  39. Viscardi RM, Sun CJ (2001) Placental lesion multiplicity: risk factor for IUGR and neonatal cranial ultrasound abnormalities. Early Human Development 62: 1–10

    Article  PubMed  CAS  Google Scholar 

  40. Estan J, Hope P (1997) Unilateral neonatal cerebral infarction in full term infants. Arch Dis Child 76: F88–F9

    Article  CAS  Google Scholar 

  41. Mercuri E, Cowan F, Rutherford M et al (1995) Ischaemic and haemorrhagic brain lesions in newborns with seizures and normal Apgar scores. Arch Dis Child 73: F67–F74

    CAS  Google Scholar 

  42. Mercuri E, Jongmans M, Bouza H et al (1999) Congenital hemiplegia in children at school age: assessment of hand function in the non-hemiplegic hand and correlation with MRI. Neuropediatrics 30: 8–13

    Article  PubMed  CAS  Google Scholar 

  43. Cowan F, Rutherford M, Groenendaal F et al (2003) Origin and timing of brain lesions in term infants with neonatal encephalopathy. Lancet 361: 736–742

    Article  PubMed  Google Scholar 

  44. Cowan FM, Pennock JM, Hanrahan JD et al (1994) Early detection of cerebral infarction and hypoxic ischemic encephalopathy in neonates using diffusion-weighted magnetic resonance imaging. Neuropediatrics 25: 172–175

    Article  PubMed  CAS  Google Scholar 

  45. Lequin MH, Dudink J, Tong KA, Obenaus A (2009) Magnetic resonance imaging in neonatal stroke. Semin Fetal Neonatal Med 14: 299–310

    Article  PubMed  CAS  Google Scholar 

  46. de Vries LS, Van der Grond J, Van Haastert IC, Groenendaal F (2005) Prediction of outcome in new-born infants with arterial ischaemic stroke using diffusion-weighted magnetic resonance imaging. Neuropediatrics 36: 12–20

    Article  PubMed  Google Scholar 

  47. Groenendaal F, Benders MJ, de Vries LS (2006) Pre-wallerian degeneration in the neonatal brain following perinatal cerebral hypoxia- ischemia demonstrated with MRI. Semin Perinatol 30: 146–150

    Google Scholar 

  48. Kirton A, Shroff M, Visvanathan T, deVeber G (2007) Quantified corticospinal tract diffusion restriction predicts neonatal stroke outcome. Stroke 38: 974–980

    Article  PubMed  Google Scholar 

  49. Bouza H, Dubowitz LMS, Rutherford M et al (1994) Late magnetic resonance imaging and clinical findings in neonates with unilateral lesions on cranial ultrasound. Dev Med Child Neurol 36: 951–964

    Article  PubMed  CAS  Google Scholar 

  50. Cowan F, Mercuri E, Groenendaal F et al (2005) Does cranial ultrasound imaging identify arterial cerebral infarction in term neonates? Arch Dis Child Fetal Neonatal Ed 90: F252–F256

    Article  PubMed  CAS  Google Scholar 

  51. Randò T, Ricci D, Mercuri E et al (2000) Periodic lateralized epileptiform discharges ( PLEDs) as early indicators of stroke in full-term infants. Neuropediatrics 31: 202–205

    Google Scholar 

  52. van Rooij LG, de Vries LS, Handryastuti S et al (2007) Neurodevelopmental outcome in term infants with status epilepticus detected with amplitude-integrated electroencephalography. Pediatrics 120: 354–363

    Google Scholar 

  53. Mercuri E, Barnett A, Rutherford M et al (2004) Neonatal cerebral infarction and neuromotor outcome at school age. Pediatrics 113: 95–100

    Article  PubMed  Google Scholar 

  54. Trauner DA, Mannino FL (1986) Neurodevelopmental outcome after neonatal cerebrovascular incident. J Pediatr 108: 459–461

    Article  PubMed  CAS  Google Scholar 

  55. Sran SK, Baumann RJ (1988) Outcome of neonatal strokes AJDC 142: 1086–1088

    CAS  Google Scholar 

  56. Allan WC, Riviello JJ Jr (1992) Perinatal cerebrovascular disease in the neonate. Parenchymal ischemic lesions in term and preterm infants. Pediatr Clin North Am 39: 621–650

    Google Scholar 

  57. Rollins NK, Morriss MC, Evans D, Perlman JM (1993) The role of early MR in the evaluation of the term infant with seizures. AJNR 15: 239–248

    Google Scholar 

  58. Koelfen W, Freund M, Varnholt V (1995) Neonatal stroke involving the middle cerebral artery in term infants: clinical presentation, EEG and imaging studies, and outcome. Dev Med Child Neurol 37: 204–212

    Google Scholar 

  59. Jan MMS, Camfield PR (1998) Outcome of neonatal stroke in fullterm infants without significant birth asphyxia. Neonatology 157: 846–848

    CAS  Google Scholar 

  60. Sreenan C, Bhargava R, Robertson CM (2000) Cerebral infarction in the term newborn: clinical presentation and long-term outcome. J Pediatr 137: 351–355

    Article  PubMed  CAS  Google Scholar 

  61. Marret S, Lardennois C, Mercier A et al (2001) Fetal and neonatal cerebral infarcts. Biol Neonate 79: 236–240

    Article  PubMed  CAS  Google Scholar 

  62. Miller V (2000) Neonatal cerebral infarction. Semin Pediatr Neurol 7: 278–288

    Article  PubMed  CAS  Google Scholar 

  63. Kirton A, deVeber G (2006) Cerebral palsy secondary to perinatal ischemic stroke. Clin Perinatol 33: 367–386

    Article  PubMed  Google Scholar 

  64. Golomb MR, Garg BP, Saha C et al (2008) Cerebral palsy after perinatal arterial ischemic stroke. J Child Neurol 23: 279–286

    Article  PubMed  Google Scholar 

  65. Ricci D, Mercuri E, Barnett A et al (2008) Cognitive outcome at early school age in term-born children with perinatally acquired middle cerebral artery territory infarction. Stroke 39: 403–410

    Article  PubMed  Google Scholar 

  66. Guzzetta A, Mercuri E, Rapisardi G et al (2003) General movements detect early signs of hemiplegia in term infants with neonatal cerebral infarction. Neuropediatrics 34: 61–66

    Article  PubMed  CAS  Google Scholar 

  67. Boardman JP, Ganesan V, Rutherford MA et al (2005) Magnetic resonance image correlates of hemiparesis after neonatal and childhood middle cerebral artery stroke. Pediatrics 115: 321–326

    Google Scholar 

  68. Golomb MR, Saha C, Garg BP et al (2007) Association of cerebral palsy with other disabilities in children with perinatal arterial ischemic stroke. Pediatr Neurol 37: 245–249

    Article  PubMed  Google Scholar 

  69. Cioni G, Sales B, Paolicelli PB et al (1999) MRI and Clinical Characteristics of children with hemiplegic cerebral palsy. Neuropaediatrics 30: 249–255

    Article  CAS  Google Scholar 

  70. Muter V, Taylor S, Vargha-Khadem F (1997) A longitudinal study of the early intellectual development in hemiplegic children. Neuropsychologia 35: 289–298

    Article  PubMed  CAS  Google Scholar 

  71. Thal D, Marchman VA, Stiles J et al (1991) Early lexical development in children with focal injury. Brain Lang 40: 491–527

    Article  PubMed  CAS  Google Scholar 

  72. Vicari S, Albertoni A, Chilosi AM et al (2000) Plasticity and reorganization during language development in children with early brain injury. Cortex 36: 31–46

    Article  PubMed  CAS  Google Scholar 

  73. Ballantyne AO, Spilkin AM, Hesselink J, Trauner DA (2008) Plasticity in the developing brain: intellectual, language and academic functions in children with ischaemic perinatal stroke. Brain 131: 2975–2985

    Article  PubMed  Google Scholar 

  74. Mercuri E, Atkinson J, Braddick O et al (1996) Visual function in perinatal cerebral infarction. Arch Dis Child 75: F76–F81

    Article  CAS  Google Scholar 

  75. Mercuri E, Spanò M, Bruccini F et al (1996) Visual outcome in children with congenital hemiplegia: correlation with MRI findings. Neuropaediatrics 27: 184–188

    Article  CAS  Google Scholar 

  76. Mercuri E, Atkinson J, Braddick O et al (1997) The aetiology of delayed visual maturation: short review and personal findings. Eur J Paed Neurol 1: 31–34

    Article  CAS  Google Scholar 

  77. Mercuri E, Anker S, Guzzetta A et al (2003) Neonatal cerebral infarction and visual function at school age. Arch Dis Child Fetal Neonatal Ed 88: F487–F491

    Article  PubMed  CAS  Google Scholar 

  78. Goodman R (1997) Psychological aspects of hemiplegia. Arch Dis Child 76: 177–178

    Article  PubMed  CAS  Google Scholar 

  79. Clancy R, Malin S, Laraque D et al (1985) Focal motor seizures heralding stroke in full term neonates. AJDC 139: 601–606

    PubMed  CAS  Google Scholar 

  80. Golomb MR, Garg BP, Carvalho KS et al (2007) Perinatal stroke and the risk of developing childhood epilepsy. J Pediatr 151: 409–413

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Pediatric Neurologic Unit, Catholic University, Rome, Italy

    Daniela Ricci

Authors
  1. Daniela Ricci
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Eugenio Mercuri
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Pediatrics, Obstetrics and Reproductive Medicine, Division of Neonatology, University of Siena General Hospital S. Maria alle Scotte Azienda Ospedaliera Universitaria Senese, Siena, Italy

    Giuseppe Buonocore (Professor of Pediatrics and Neonatology, Head of School of Pediatrics) (Professor of Pediatrics and Neonatology, Head of School of Pediatrics)

  2. University of Siena, Siena, Italy

    Rodolfo Bracci (Formerly Professor of Pediatrics and Head of Department of Pediatrics, Obstetrics and Reproductive Medicine) (Formerly Professor of Pediatrics and Head of Department of Pediatrics, Obstetrics and Reproductive Medicine)

  3. University of Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

  4. Department of Women’s and Children’s Health, Institute of Translational Medicine, Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

  5. Liverpool Women’s Hospital, Liverpool, UK

    Michael Weindling (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery) (Professor of Perinatal Medicine, Director of Postgraduate Research, Head of School of Paediatrics Mersey Deanery)

Rights and permissions

Reprints and permissions

Copyright information

© 2012 Springer-Verlag Italia

About this chapter

Cite this chapter

Ricci, D., Mercuri, E. (2012). Neonatal Arterial Stroke. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Milano. https://doi.org/10.1007/978-88-470-1405-3_139

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-1405-3_139

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-1404-6

  • Online ISBN: 978-88-470-1405-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation