Preterm Arterial Ischemic Stroke

Semin Fetal Neonatal Med. 2009 Oct;14(5):272-7. doi: 10.1016/j.siny.2009.07.002. Epub 2009 Aug 4.

Abstract

Most studies about perinatal arterial ischemic stroke (PAIS) exclude preterm infants. In a prospectively studied hospital-based population, 42% of our 73 newborn infants with PAIS had a gestational age (GA) < or =36 weeks. PAIS was present on the left in 61% of the preterm infants and bilateral in 7%. The middle cerebral artery (MCA) was most often affected. Involvement of the lenticulostriate branches was common among preterm infants with GA of 28-32 weeks, and involvement of the MCA main branch was seen in almost all with a GA>33 weeks. Twin-to-twin transfusion syndrome, fetal heart rate abnormality and hypoglycemia were independent risk factors. No maternal risk factors could be identified. Comparing neurodevelopmental outcome, infants with a main branch MCA infarct, irrespective of being preterm or full-term, were found to be most at risk of motor/cognitive impairment. Preterm infants with PAIS had more language problems at 2 years of age.

Publication types

  • Review

MeSH terms

  • Brain / blood supply
  • Brain / growth & development
  • Brain Ischemia* / complications
  • Brain Ischemia* / diagnosis
  • Brain Ischemia* / diagnostic imaging
  • Brain Ischemia* / epidemiology
  • Female
  • Fetofetal Transfusion / complications
  • Follow-Up Studies
  • Humans
  • Incidence
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases* / diagnosis
  • Infant, Premature, Diseases* / diagnostic imaging
  • Infant, Premature, Diseases* / epidemiology
  • Infarction, Middle Cerebral Artery / epidemiology
  • Language Development Disorders / etiology
  • Male
  • Pregnancy
  • Risk Factors
  • Stroke* / complications
  • Stroke* / diagnosis
  • Stroke* / diagnostic imaging
  • Stroke* / epidemiology
  • Treatment Outcome
  • Ultrasonography