Neonatal stroke: Clinical characteristics and cerebral blood flow velocity measurements
The clinical courses of 8 term infants with focal cerebral infarction or neonatal stroke were studied to determine whether such infants can be identified by current markers of perinatal distress, and whether changes in cerebral blood flow velocity (CBFV) occur during the acute phase of the disease....
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| Veröffentlicht in: | Pediatric neurology 1994-11, Vol.11 (4), p.281-284 |
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| container_title | Pediatric neurology |
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| creator | Perlman, Jeffrey M. Rollins, Nancy K. Evans, Denise |
| description | The clinical courses of 8 term infants with focal cerebral infarction or neonatal stroke were studied to determine whether such infants can be identified by current markers of perinatal distress, and whether changes in cerebral blood flow velocity (CBFV) occur during the acute phase of the disease. CBFV was measured from the middle cerebral artery (MCA) and anterior cerebral artery (ACA) utilizing duplex Doppler. Seven of the 8 patients required no resuscitation in the delivery room; 1 infant required brief bag and mask ventilation. No infant had evidence of severe fetal acidemia (i.e., cord pH |
| doi_str_mv | 10.1016/0887-8994(94)90002-7 |
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CBFV was measured from the middle cerebral artery (MCA) and anterior cerebral artery (ACA) utilizing duplex Doppler. Seven of the 8 patients required no resuscitation in the delivery room; 1 infant required brief bag and mask ventilation. No infant had evidence of severe fetal acidemia (i.e., cord pH <7). All 8 infants were initially admitted to the newborn nursery. Infants were identified on the basis of abnormal clinical findings observed during the first 48 hours: seizures (n = 6) and hypotonia and apnea (n = 2). Serum electrolytes, calcium, magnesium, and glucose levels were normal, and the sepsis evaluation including a spinal tap was sterile in all patients. Neuroimaging revealed nonhemorrhagic left focal MCA infarction (n = 6) and right focal MCA infarction (n = 2). Duplex Doppler demonstrated transient ipsilateral decreases in CBFV as compared to the contralateral unaffected side at clinical presentation in 4 infants. In 2 of these infants the decrease in CBFV involved both the MCA and ACA, and in 2 infants, only the MCA vessels. These side-to-side differences were not present at subsequent CBFV measurements. The data indicate that infants who develop neonatal stroke cannot be distinguished from infants who do not develop the lesion by current markers of perinatal distress. 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CBFV was measured from the middle cerebral artery (MCA) and anterior cerebral artery (ACA) utilizing duplex Doppler. Seven of the 8 patients required no resuscitation in the delivery room; 1 infant required brief bag and mask ventilation. No infant had evidence of severe fetal acidemia (i.e., cord pH <7). All 8 infants were initially admitted to the newborn nursery. Infants were identified on the basis of abnormal clinical findings observed during the first 48 hours: seizures (n = 6) and hypotonia and apnea (n = 2). Serum electrolytes, calcium, magnesium, and glucose levels were normal, and the sepsis evaluation including a spinal tap was sterile in all patients. Neuroimaging revealed nonhemorrhagic left focal MCA infarction (n = 6) and right focal MCA infarction (n = 2). Duplex Doppler demonstrated transient ipsilateral decreases in CBFV as compared to the contralateral unaffected side at clinical presentation in 4 infants. In 2 of these infants the decrease in CBFV involved both the MCA and ACA, and in 2 infants, only the MCA vessels. These side-to-side differences were not present at subsequent CBFV measurements. The data indicate that infants who develop neonatal stroke cannot be distinguished from infants who do not develop the lesion by current markers of perinatal distress. Because neonatal stroke frequently occurs as an unanticipated event, prevention may not be possible.</description><subject>Biological and medical sciences</subject><subject>Blood Flow Velocity - physiology</subject><subject>Brain - blood supply</subject><subject>Cerebral Infarction - diagnosis</subject><subject>Cerebral Infarction - physiopathology</subject><subject>Cerebrovascular Disorders - diagnosis</subject><subject>Cerebrovascular Disorders - physiopathology</subject><subject>Diagnosis, Differential</subject><subject>Female</subject><subject>Humans</subject><subject>Infant, Newborn</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Neurologic Examination</subject><subject>Neurology</subject><subject>Regional Blood Flow - physiology</subject><subject>Risk Factors</subject><subject>Ultrasonography, Doppler, Transcranial</subject><subject>Vascular diseases and vascular malformations of the nervous system</subject><issn>0887-8994</issn><issn>1873-5150</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>1994</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kE2LFDEQhoO4rOPqP1Dog4geWiudTD72IMiguwuLXhSPoTpdjdHuzppkVvbfm2aGOQoFBfU-VRQPYy84vOPA1XswRrfGWvnGyrcWALpWP2IbbrRot3wLj9nmhDxhT3P-VZmt7eQ5O9caOmXUhv34QnHBglOTS4q_6bLZTWEJvg78T0zoC6WQS_C5wWVoPCXqUw37KcahGaf4t7mnKfpQHpqZMO8TzbSU_IydjThlen7sF-z750_fdtft7derm93H29YLo0rbocBBoNZowXbbnkAhmdGrHvmgeml8p0FyMUhhlUfQiqyFznCpSaIx4oK9Pty9S_HPnnJxc8iepgkXivvstDbAuZQVlAfQp5hzotHdpTBjenAc3OrTrbLcKsuttfp0uq69PN7f9zMNp6WjwJq_OuaYq7Qx4eJDPmFC6A44VOzDAaPq4j5QctkHWjwNIZEvbojh_3_8A8hekc4</recordid><startdate>19941101</startdate><enddate>19941101</enddate><creator>Perlman, Jeffrey M.</creator><creator>Rollins, Nancy K.</creator><creator>Evans, Denise</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>19941101</creationdate><title>Neonatal stroke: Clinical characteristics and cerebral blood flow velocity measurements</title><author>Perlman, Jeffrey M. ; Rollins, Nancy K. ; Evans, Denise</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c386t-2a3ad3a77a90925be06ae8fc6ba1d6b48c270413d4396ca076e99028147e4a883</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>1994</creationdate><topic>Biological and medical sciences</topic><topic>Blood Flow Velocity - physiology</topic><topic>Brain - blood supply</topic><topic>Cerebral Infarction - diagnosis</topic><topic>Cerebral Infarction - physiopathology</topic><topic>Cerebrovascular Disorders - diagnosis</topic><topic>Cerebrovascular Disorders - physiopathology</topic><topic>Diagnosis, Differential</topic><topic>Female</topic><topic>Humans</topic><topic>Infant, Newborn</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Neurologic Examination</topic><topic>Neurology</topic><topic>Regional Blood Flow - physiology</topic><topic>Risk Factors</topic><topic>Ultrasonography, Doppler, Transcranial</topic><topic>Vascular diseases and vascular malformations of the nervous system</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Perlman, Jeffrey M.</creatorcontrib><creatorcontrib>Rollins, Nancy K.</creatorcontrib><creatorcontrib>Evans, Denise</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatric neurology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Perlman, Jeffrey M.</au><au>Rollins, Nancy K.</au><au>Evans, Denise</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Neonatal stroke: Clinical characteristics and cerebral blood flow velocity measurements</atitle><jtitle>Pediatric neurology</jtitle><addtitle>Pediatr Neurol</addtitle><date>1994-11-01</date><risdate>1994</risdate><volume>11</volume><issue>4</issue><spage>281</spage><epage>284</epage><pages>281-284</pages><issn>0887-8994</issn><eissn>1873-5150</eissn><abstract>The clinical courses of 8 term infants with focal cerebral infarction or neonatal stroke were studied to determine whether such infants can be identified by current markers of perinatal distress, and whether changes in cerebral blood flow velocity (CBFV) occur during the acute phase of the disease. CBFV was measured from the middle cerebral artery (MCA) and anterior cerebral artery (ACA) utilizing duplex Doppler. Seven of the 8 patients required no resuscitation in the delivery room; 1 infant required brief bag and mask ventilation. No infant had evidence of severe fetal acidemia (i.e., cord pH <7). All 8 infants were initially admitted to the newborn nursery. Infants were identified on the basis of abnormal clinical findings observed during the first 48 hours: seizures (n = 6) and hypotonia and apnea (n = 2). Serum electrolytes, calcium, magnesium, and glucose levels were normal, and the sepsis evaluation including a spinal tap was sterile in all patients. Neuroimaging revealed nonhemorrhagic left focal MCA infarction (n = 6) and right focal MCA infarction (n = 2). Duplex Doppler demonstrated transient ipsilateral decreases in CBFV as compared to the contralateral unaffected side at clinical presentation in 4 infants. In 2 of these infants the decrease in CBFV involved both the MCA and ACA, and in 2 infants, only the MCA vessels. These side-to-side differences were not present at subsequent CBFV measurements. The data indicate that infants who develop neonatal stroke cannot be distinguished from infants who do not develop the lesion by current markers of perinatal distress. Because neonatal stroke frequently occurs as an unanticipated event, prevention may not be possible.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>7702686</pmid><doi>10.1016/0887-8994(94)90002-7</doi><tpages>4</tpages></addata></record> |
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| ispartof | Pediatric neurology, 1994-11, Vol.11 (4), p.281-284 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Biological and medical sciences Blood Flow Velocity - physiology Brain - blood supply Cerebral Infarction - diagnosis Cerebral Infarction - physiopathology Cerebrovascular Disorders - diagnosis Cerebrovascular Disorders - physiopathology Diagnosis, Differential Female Humans Infant, Newborn Male Medical sciences Neurologic Examination Neurology Regional Blood Flow - physiology Risk Factors Ultrasonography, Doppler, Transcranial Vascular diseases and vascular malformations of the nervous system |
| title | Neonatal stroke: Clinical characteristics and cerebral blood flow velocity measurements |
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