Preterm arterial ischemic stroke

Summary 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) ≤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.