Preterm arterial ischemic stroke.
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.
Benders
M J N L
MJ
Department of Neonatology, Wilhelmina Children's Hospital, UMC Utrecht, The Netherlands.
Groenendaal
F
F
De Vries
L S
LS
D001921:Brain / Q000098:blood supply / Q000254:growth & development; D002545:Brain Ischemia / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D005330:Fetofetal Transfusion / Q000150:complications; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D020244:Infarction, Middle Cerebral Artery / Q000453:epidemiology; D007805:Language Development Disorders / Q000209:etiology; D008297:Male; D011247:Pregnancy; D012307:Risk Factors; D020521:Stroke / Q000150:complications / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000453:epidemiology; D016896:Treatment Outcome; D014463:Ultrasonography