title: Prevalence of Stroke in Neonates Who Admitted With Seizures in Neonatal Intensive Care Unit.
abstract: OBJECTIVE
  Prevalence of neonatal stroke has been reported 1/2300-1/4000 live births and accounts for 12-20% of the cases of neonatal seizures. Although stroke has been introduced as the second cause of the neonatal seizures in literatures, it may remain unclear in diagnostic evaluations of seizure in neonates. This study was performed to assess the prevalence of stroke in neonates with seizure.
  
  
  METHODS
  In this cross-sectional study, all neonates ≥ 28 weeks of gestation with a diagnosis of seizures admitted to the NICU of Boo-Ali Sina Hospital in Sari, north of Iran, were enrolled. Brain CT scan and a Transcranial Doppler ultrasonography were performed for the all cases. In cases that stroke were reported in one or two above modalities, an MRI was also performed and prevalence of stroke was reported. Putative risk factors of stroke were analyzed with univariate and multivariate statistical methods.
  
  
  RESULTS
  From 174 newborn infants, 75.3% of neonates were male. Prevalence of stroke was 8%, 2.3% and 3.4% in Doppler ultrasonography, CT scan and MRI reports respectively. Umbilical venous catheterization was the risk factor of stroke in the univariate and multivariate analysis (P= 0.001; OR, 10.39; 95% CI, 2.72- 39.77). The most common form of seizure was focal clonic seizures (78.6%) in neonates with stroke.
  
  
  CONCLUSIONS
  Investigation of stroke as an etiology of neonatal seizures is essential because seizure may be the only symptom of neonatal cerebral infarction. Doppler ultrasonography can be a valuable diagnostic tool at first in critically ill neonates or in situations that MRI is not available primarily. Further studies with notice to outcome assessment of these infants recommended.
authors.affiliation: Pediatrics Department, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Roya
authors.initials: R
authors.lastname: Farhadi
authors.affiliation: Radiology Department, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Abdolrasool
authors.initials: A
authors.lastname: Alaee
authors.affiliation: Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Zahra
authors.initials: Z
authors.lastname: Alipour
authors.affiliation: Pediatric Neurology Department, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Abbaskhanian
authors.affiliation: Pediatrics Department, Mazandaran University of Medical Sciences, Sari, Iran.
authors.forename: Maryam
authors.initials: M
authors.lastname: Nakhshab
authors.affiliation: Pediatrician, Emergency Medicine Department, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hojjat
authors.initials: H
authors.lastname: Derakhshanfar
keywords: Neonate; Seizure; Stroke; Transcranial Doppler Sonography