[Focal cerebral ischemic or hemorrhagic lesions in the term newborn. Review of the last decade].
BACKGROUND
Although focal cerebral ischemic or hemorrhagic lesions are infrequent in the term newborn, they must be considered when neurologic symptoms appear, especially when seizures are present.


OBJECTIVE
Possible risk factors to suffer from these pathologies have been studied, as well as their evolution, to try to give a prognosis.


METHODS
The term newborns with focal ischemic or hemorrhagic cerebral lesions who presented symptoms in the neonatal period have been studied for 10 years (January 1990-March 2000) in our Children s Hospital Miguel Servet of Zaragoza (Spain). The newborns have been studied in our hospital, and their evolution followed in the Neuropediatric Consulting Room. From each case data about familiar history, pregnancy, labor, clinical manifestations, physical examination, complementary studies, diagnosis and neurodevelopment evolution have been collected. RESULTS. From the nine cases found, four were infarctions of the left medial cerebral artery, and five were hemorrhages. Except in two cases in which an important birth trauma was present, any other antecedent that could be the cause was found. All except one manifested as seizures. Neuroimaging studies visualized the stroke in all of them. A slight motor deficit remains in seven children, and it is severe in one.


CONCLUSIONS
Cerebrovascular strokes are infrequent in term newborns. Most of the times their etiology is not found. These accidents usually manifestate as focal seizures in the immediate neonatal period, and neuroimaging studies (ECO-TC) are essential for the diagnosis. The long term evolution is favorable in most of the cases, although focal motor deficit remains present frequently.
Ruiz-Escusol
S
S
Servicio de Neuropediatría; Hospital Infantil Miguel Servet, Zaragoza, 50009, España.
Medrano-Marina
P
P
Galván-Mansó
M
M
Marco-Tello
A
A
López-Pisón
J
J
Rebage-Moisés
V
V
D001921:Brain / Q000098:blood supply* / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis*; D002543:Cerebral Hemorrhage / Q000150:complications / Q000175:diagnosis*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008423:Maternal Age; D019957:Motor Skills Disorders / Q000209:etiology; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed