Utilize este identificador para referenciar este registo: http://hdl.handle.net/10400.17/2217
Título: Perinatal Ischemic Stroke: a Five-Year Retrospective Study in a Level-III Maternity
Outros títulos: Acidente Vascular Cerebral Isquémico Perinatal: Estudo Retrospectivo de 5 Anos em Maternidade Nível III
Autor: Machado, V
Pimentel, S
Pinto, F
Nona, J
Palavras-chave: MAC PED
Brain Ischemia/diagnosis
Age Factors
Risk Factors
Brain Ischemia/epidemiology
Retrospective Studies
Brain Ischemia/etiology
Follow-Up Studies
Infant, Newborn
Magnetic Resonance Imaging
Time Factors
Data: 2015
Editora: Scielo
Citação: Einstein (Sao Paulo). 2015 Jan-Mar;13(1):65-71
Resumo: Objective To study the incidence, clinical presentation, risk factors, imaging diagnosis, and clinical outcome of perinatal stroke. Methods Data was retrospectively collected from full-term newborns admitted to the neonatal unit of a level III maternity in Lisbon with cerebral stroke, from January 2007 to December 2011. Results There were 11 cases of stroke: nine were arterial ischemic stroke and two were cerebral venous sinus thrombosis. We estimated an incidence of arterial ischemic stroke of 1.6/5,000 births and of cerebral venous sinus thrombosis of 7.2/100,000 births. There were two cases of recurrent stroke. Eight patients presented with symptoms while the remaining three were asymptomatic and incidentally diagnosed. The most frequently registered symptoms (8/11) were seizures; in that, generalized clonic (3/8) and focal clonic (5/8). Strokes were more commonly left-sided (9/11), and the most affected artery was the left middle cerebral artery (8/11). Transfontanelle ultrasound was positive in most of the patients (10/11), and stroke was confirmed by cerebral magnetic resonance in all patients. Electroencephalographic recordings were carried out in five patients and were abnormal in three (focal abnormalities n=2, burst-suppression pattern n=1). Eight patients had previously identified risk factors for neonatal stroke which included obstetric and neonatal causes. Ten patients were followed up at outpatients setting; four patients developed motor deficits and one presented with epilepsy. Conclusions Although a modest and heterogeneous sample, this study emphasizes the need for a high level of suspicion when it comes to neonatal stroke, primarily in the presence of risk factors. The prevalence of neurological sequelae in our series supports the need of long-term follow-up and early intervention strategies.
Peer review: yes
URI: http://hdl.handle.net/10400.17/2217
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