title: Neonatal posterior cerebral artery stroke: clinical presentation, MRI findings, and outcome.
abstract: OBJECTIVE
  To report the clinical presentation, magnetic resonance imaging (MRI) findings, and follow-up data of newborn infants with perinatal arterial ischemic stroke in the territory of the posterior cerebral artery (PCA).
  
  
  METHODS
  Data on 18 newborn infants from three neonatal intensive care units (11 males, seven females) with an MRI-confirmed PCA stroke were analysed and reported. Infants were born at a mean gestational age of 38.7 weeks (SD 3.4) with a mean birthweight of 3244g (SD 850).
  
  
  RESULTS
  Fourteen infants presented with clinical seizures. Five of these had associated hypoxic-ischemic encephalopathy, four had hypoglycaemia, and five had neither hypoxic-ischemic encephalopathy nor hypoglycaemia. Subclinical seizures were present in one infant with hypoxic-ischemic encephalopathy and one with meningitis. One preterm infant presented with apnoeas and one had hypoxic-ischemic encephalopathy without seizures. Neurodevelopmental follow-up of 17 children at a median age of 36 months (SD 28, range 12-120mo) showed five with a global delay. Two children with additional injury developed postneonatal epilepsy and one child with extensive injury developed hemiplegia. A visual field defect was observed in nine children (six hemianopia, three quadrantanopia). In the 11 children with a second MRI at 3 months, the asymmetry of the optic radiation correlated with the development of a visual field deficit.
  
  
  CONCLUSIONS
  Outcome after PCA stroke is fairly good, depending on additional brain injury. Follow-up is required, as subsequent visual field defects are frequently observed. Further research will be needed to clarify the role of hypoglycaemia in perinatal arterial ischemic stroke.
authors: Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
authors: Niek E
authors: NE
authors: van der Aa
authors: Jeroen
authors: J
authors: Dudink
authors: Manon J N L
authors: MJ
authors: Benders
authors: Paul
authors: P
authors: Govaert
authors: Henrica L M
authors: HL
authors: van Straaten
authors: Giorgio L
authors: GL
authors: Porro
authors: Floris
authors: F
authors: Groenendaal
authors: Linda S
authors: LS
authors: de Vries
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000503:physiopathology*; D020762:Infarction, Posterior Cerebral Artery / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D008297:Male; D012189:Retrospective Studies; D016896:Treatment Outcome