Stroke in the newborn. Clinical report and literature review
Background. Stroke in the newborn or perinatal stroke (PS) is an acute brain ischemia with the duration up to the first 28 days of life with neurological symptoms or without them. Therefore, the diagnostics in clinical practice can become tricky due to misleading expression of this clinical syndrom...
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| Format: | Article |
| Language: | English |
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Vilnius University Press
2019-12-01
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| Series: | Neurologijos seminarai |
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| Online Access: | https://www.journals.vu.lt/neurologijos_seminarai/article/view/27768 |
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| author | R. Jakuškienė V. Joneliūnaitė U. Jucevičiūtė |
| author_facet | R. Jakuškienė V. Joneliūnaitė U. Jucevičiūtė |
| author_sort | R. Jakuškienė |
| collection | DOAJ |
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Background. Stroke in the newborn or perinatal stroke (PS) is an acute brain ischemia with the duration up to the first 28 days of life with neurological symptoms or without them. Therefore, the diagnostics in clinical practice can become tricky due to misleading expression of this clinical syndrome. Whilst rare (1 in 1600-4000 cases), PS has 6 times higher prevalence in newborns compared to older children. Consequently, slight neurological symptoms such as convulsions, changes or asymmetry in muscle tone, exaggeration, weakening or disappearance of primitive reflexes should be taken into account urgently. According to American Heart Association’s studies in 2019, two thirds of perinatal victims have neurological disability or delayed mental performance.
Case report. In this article we present a clinical case of perinatal ischemic stroke and literature review. We analyze acute brain ischemia in a newborn which developed during the first 12-24 hours of life with severe neurological symptoms and involved the area of the right internal carotid artery. Apart from “fencing reflex” and feeding rejection, epilepsy was not marked in the history of PS onset. The doctors agreed on the diagnosis based on neurosonography and computed tomography results, and the decision of performing craniotomy was made due to the risk of hemorrhagic stroke.
Conclusions. Diagnosing perinatal stroke is a crucial and difficult task for all pediatricians because of its poor clinical expression and the necessity of urgent actions in order to avoid long term outcomes. Hence, thorough neurological exam and neuroimaging is an essential point in early diagnostics. Clinical practice reveals that there are no common guidelines to diagnose and manage perinatal stroke as an extremely urgent pathology which has a significant impact on a child’s further mental development.
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| format | Article |
| id | doaj-art-0ff30d314e9e471283d91f672263b479 |
| institution | Kabale University |
| issn | 1392-3064 2424-5917 |
| language | English |
| publishDate | 2019-12-01 |
| publisher | Vilnius University Press |
| record_format | Article |
| series | Neurologijos seminarai |
| spelling | doaj-art-0ff30d314e9e471283d91f672263b4792025-01-20T18:22:52ZengVilnius University PressNeurologijos seminarai1392-30642424-59172019-12-01234(82)10.29014/ns.2019.27Stroke in the newborn. Clinical report and literature reviewR. Jakuškienė 0V. Joneliūnaitė 1U. Jucevičiūtė 2Lithuanian University of Health SciencesLithuanian University of Health SciencesLithuanian University of Health Sciences Background. Stroke in the newborn or perinatal stroke (PS) is an acute brain ischemia with the duration up to the first 28 days of life with neurological symptoms or without them. Therefore, the diagnostics in clinical practice can become tricky due to misleading expression of this clinical syndrome. Whilst rare (1 in 1600-4000 cases), PS has 6 times higher prevalence in newborns compared to older children. Consequently, slight neurological symptoms such as convulsions, changes or asymmetry in muscle tone, exaggeration, weakening or disappearance of primitive reflexes should be taken into account urgently. According to American Heart Association’s studies in 2019, two thirds of perinatal victims have neurological disability or delayed mental performance. Case report. In this article we present a clinical case of perinatal ischemic stroke and literature review. We analyze acute brain ischemia in a newborn which developed during the first 12-24 hours of life with severe neurological symptoms and involved the area of the right internal carotid artery. Apart from “fencing reflex” and feeding rejection, epilepsy was not marked in the history of PS onset. The doctors agreed on the diagnosis based on neurosonography and computed tomography results, and the decision of performing craniotomy was made due to the risk of hemorrhagic stroke. Conclusions. Diagnosing perinatal stroke is a crucial and difficult task for all pediatricians because of its poor clinical expression and the necessity of urgent actions in order to avoid long term outcomes. Hence, thorough neurological exam and neuroimaging is an essential point in early diagnostics. Clinical practice reveals that there are no common guidelines to diagnose and manage perinatal stroke as an extremely urgent pathology which has a significant impact on a child’s further mental development. https://www.journals.vu.lt/neurologijos_seminarai/article/view/27768newbornperinatal strokebrain ischemiacraniotomy |
| spellingShingle | R. Jakuškienė V. Joneliūnaitė U. Jucevičiūtė Stroke in the newborn. Clinical report and literature review Neurologijos seminarai newborn perinatal stroke brain ischemia craniotomy |
| title | Stroke in the newborn. Clinical report and literature review |
| title_full | Stroke in the newborn. Clinical report and literature review |
| title_fullStr | Stroke in the newborn. Clinical report and literature review |
| title_full_unstemmed | Stroke in the newborn. Clinical report and literature review |
| title_short | Stroke in the newborn. Clinical report and literature review |
| title_sort | stroke in the newborn clinical report and literature review |
| topic | newborn perinatal stroke brain ischemia craniotomy |
| url | https://www.journals.vu.lt/neurologijos_seminarai/article/view/27768 |
| work_keys_str_mv | AT rjakuskiene strokeinthenewbornclinicalreportandliteraturereview AT vjoneliunaite strokeinthenewbornclinicalreportandliteraturereview AT ujuceviciute strokeinthenewbornclinicalreportandliteraturereview |