Prenatal Stroke Suggested by Intrauterine Ultrasound and Confirmed by Magnetic Resonance Imaging

Amato, Maurizio; Hüppi, PS; Herschkowitz, N; Huber, P

doi:10.1055/s-2008-1071425

Cited by 19 publications

(5 citation statements)

References 10 publications

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“…It is difficult to know exactly when arterial ischemic stroke occurs in neonates. Prenatal infarct may be identified when tissue loss is seen on prenatal ultrasonography, 25 or when cranial ultrasonography or CT performed in the neonatal period shows signs of tissue loss suggestive of old infarct. 16 MRI diffusion-weighted imaging demonstrates acute infarct within hours.…”

Section: Discussionmentioning

confidence: 99%

Cranial Ultrasonography Has a Low Sensitivity for Detecting Arterial Ischemic Stroke in Term Neonates

et al. 2003

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The aim of this study was to investigate the sensitivity of cranial ultrasonography for detecting acute arterial ischemic stroke in term neonates. Thirty-six neonates with gestational age > or = 36 weeks who had cranial ultrasonography followed by computed tomography (CT) or magnetic resonance imaging (MRI) confirming arterial ischemic stroke were identified from a consecutive cohort study of all children diagnosed with arterial ischemic stroke by CT or MRI and seen at Chedoke McMaster Hospital between January 1992 and December 1998 or at The Hospital for Sick Children between January 1992 and December 2000. Cranial ultrasonography demonstrated focal abnormalities in 11 patients, giving the initial cranial ultrasonography a sensitivity of 30.56% for identifying neonates with infarction (95% CI 15.5-45.5%). The sensitivity of cranial ultrasonography performed in the two pediatric referral centers (Chedoke McMaster Hospital and Hospital for Sick Children; n = 19) was higher than that in community hospitals (n = 17) (47.3% versus 11.7%; P =.031). Neonates with suspected infarction should be evaluated with CT or MRI.

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Section: Discussionmentioning

confidence: 99%

Cranial Ultrasonography Has a Low Sensitivity for Detecting Arterial Ischemic Stroke in Term Neonates

et al. 2003

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“…It is less sensitive than MRI, however, for the detection of either acute or small ischemic lesions 5 . Therefore, in most cases, the onset time is often speculative on the basis of sudden fetal distress or abnormal signs in US imaging or CT scans performed shortly after birth 3 . In postpartum onset, brain infarctions with hemorrhagic lesions were evident in only 20% of cases 6 .…”

Section: Discussionmentioning

confidence: 99%

Brain infarction localized on left inferior temporal gyrus of presumed fetal onset

Yamamoto

Kohno

Kato

et al. 2010

J of Obstet and Gynaecol

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Idiopathic perinatal cerebral infarction is recognized to be more common in the preterm infant than previously realized. However, the pathogenic mechanisms and the onset time remain unclear. We encountered an extremely low birth weight female infant with severe intrauterine growth retardation and brain infarction localized on the left inferior temporal gyrus. The onset of the infarction and the precise sequential changes were evaluated with blood data, cranial ultrasound imaging, computed tomography, magnetic resonance imaging and magnetic resonance angiography. This is the first published fetal case with brain infarction specifically localized on the left inferior temporal gyrus. Careful observation with serial brain imaging is indispensable for high-risk infarction groups, such as preterm infants with severe intrauterine growth retardation, to detect neurological abnormality earlier and precisely.

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“…Thrombosis and infarction in the placenta are associated with peri-and neonatal infarction and resultant disability, the most commonly presumed mechanism being embolization to the fetus. [16][17][18][19][20][21][22] Pregnancy and the Puerperium Are Prothrombotic States Hemostasis in the healthy adult is a balance of pro-and anticoagulant reactions. However, for healthy women there is a shift toward prothrombotic reactions during and just after gestation.…”

Section: Two Circulations and A Placentamentioning

confidence: 99%

The Contribution of Prothrombotic Disorders to Peri- and Neonatal Ischemic Stroke

2003

Semin Thromb Hemost

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Prothrombotic disorders are believed to be important contributors to the etiology of peri- and neonatal arterial ischemic stroke and sinovenous thrombosis, which may lead to life-long disability. This article reviews hematological issues unique to the perinatal period, including: the significance of the placenta as the interface between maternal and fetal circulations; normal changes in the coagulation system of mothers during and just after gestation; and the significance of prothrombotic disorders in the mother and/or fetus. Other possible maternal and neonatal contributors to peri- and neonatal stroke are discussed, including: infection, pre-eclampsia, diabetes, and drug use in the mother; and infection, dehydration, complex congenital heart disease, extracorporeal membrane oxygenation, and catheter placement in the neonate. Possible approaches to preventing and treating perinatal and neonatal stroke are presented.

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Prenatal Stroke Suggested by Intrauterine Ultrasound and Confirmed by Magnetic Resonance Imaging

Cited by 19 publications

References 10 publications

Cranial Ultrasonography Has a Low Sensitivity for Detecting Arterial Ischemic Stroke in Term Neonates

Cranial Ultrasonography Has a Low Sensitivity for Detecting Arterial Ischemic Stroke in Term Neonates

Brain infarction localized on left inferior temporal gyrus of presumed fetal onset

The Contribution of Prothrombotic Disorders to Peri- and Neonatal Ischemic Stroke

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