Review
BibTex RIS Cite

Perinatal Stroke

Year 2017, Volume: 9 Issue: 6, 13 - 16, 17.11.2017

Abstract

Abstract

Perinatal stroke is a heterogeneous group of disease characterized by the cessation of cerebral blood flow due to arterial or venous thrombosis or emboli during the 20th of gestation and postnatal 28 days of life. Cerebral bleeding is rare but may be present in sinus venosus thrombosis. Risk factors include hypoxia, hypercoagulability, endothelial damage, infertility, preeclampsia, thrombophilia, intrauterine growth retardation, smoking, preterm rupture of membranes, maternal fever and chorioamnionitis. Most of the cases of PS are seen in term infants in the neonatal period but focal neurological signs are rare. Most common cause of neonatal seizures after perinatal ischemia is perinatal stroke. Diagnosis is made by cranial ultrasonography and MRI. There is no definite treatment for PS and most of the time, only supportive treatment can be done. Half of the PS cases die in the intrauterine period, are still born or terminated. One fifth of live-born infants die in the neonatal period whereas half of the living cases have neurological sequalae at 6 years of age. Mortality is rare after neonatal stroke. Cerebral venous thrombosis may have genetic or acquired causes. Treatment is supportive and mortality is rare.

References

  • Kaynaklar 1.Raju TN, Nelson KB, Ferriero D, Lynch JK. Ischemic perina-tal stroke: summary of a workshop sponsored by the Natio-nal Institute of Child Health and Human Development and theNational Institute of Neurological Disorders and Stroke. Pe-diatrics 2007; 120: 609-16. 2.Burns CM; Rutherford MA, Boardrman JP, et al. Pattern of ce-rebral injury and neurodevelopmental outcomes after sympto-matic neonatal hypoglycemia. Pediatrics 2008; 122: 65-74. 3.deVries LS, Verboon Maciolek MA, Cowan FM, et al. The roleof cranial ultrasound and magnetic resonance imaging in thediagnosis of infections of the central nervous system. Early HumDev 2006; 82: 819-25. 4.Berfelo FJ, Kersbergen KJ, van Ommen CH, et al. Neonatalcerebral sinovenous thrombosis from symptom to outcome. Stro-ke 2010; 41: 1382-88. 5.Ramenghi LA, Govaert P, Fumagalli M, et al. Neonatal cereb-ral sinovenous thrombosis. Semin Fetal Neonatal Med 2009;14: 278-83. 6.Rutherford MA, Ramengni LA, Cowan FM. Neonatal stroke.Arch Dis Child Fetal Neonatal Ed 2012; 97: F377-F384. 7.Levine D. Case 46: Encephalomalacia in surviving twin afterdeath of monochorionic co-twin. Radiology 2002; 223: 392-95. 8.Özduman K, deVeber G, Ment LR. Stroke in the fetus and neona-te. In: Perlman JM, ed. Neurology: Neonatology Questions andControversies. Philadelphia: Saunders-Elsevier, 2008: 88-121. 9.Dale ST, Coleman LT. Neonatal alloimmune thrombocytope-nia: Antenatal and postnatal imaging findings in the pediat-ric brain. Am J Neuroradiol 2002; 23: 1457-65. 10.Pineda M, Campistol J, Vilaseca MA, et al. An atypical French formof pyruvate carboxylase deficiency. Brain Dev 1995; 12: 276-79. 11.Günther G, Junker R, Strater R, et al. Symptomatic ischemicstroke in full term neonates: role of acquired and genetic proth-rombotic risk factors. Stroke 2000; 31: 2437-41. 12.Miller SP, McQuillen PS, Hamrick S, et al. Abnormal braindevelopment in newborns with congenital heart disease. N EnglJ Med 2007; 357: 1928-38. 13.Miller V. Neonatal cerebral infarction. Semin Pediatr Neurol2000; 7: 278-88. 14.deVries LS; Groenendaal F, Eken P, et al. Infarcts in the vas-cular distribution of the middle cerebral artery in preterm andfull-term infant. Neuropediatrics 1997; 28: 88-96. 15.Perlman JM, Rollins NK; Evans D. Neonatal stroke: clinicalcharacteristics and cerebral blood flow velocity measurement.Pediatr Neurol 1994; 11: 281-84. 16.Uvebrant P. Hemiplegic cerebral palsy. Aetiology and outco-me. Acta Paediatr Scand Suppl 1988; 345: 1-100. 17.Estan J, Hope P. Unilateral neonatal cerebral infarction in full terminfants. Arch Dis Child Fetal Neonatal Ed 1997; 76: F88-93. 18.Lehman LL, Rivkin MJ. Perinatal arterial ischemic stroke: pre-sentation, risk factors, evaluation, and outcome. Pediatr Neu-rol 2014; 51: 760-68. 19.Lee J, Croen LA, Lindan C, et al. Predictors of outcome in pe-rinatal arterial stroke: a population based study. Ann Neurol2005; 58: 303-308. 20.Guzzetta A, Pecini C, Biagi L, et al. Language organizationin left perinatal stroke. Neuropediatrics 2008; 39: 157-63. 21.Roach ES; Golomb MR, Adams R, et al. Management of stro-ke in infants and children: a scientific statement from a Spe-cial Writing Group of American Heart Association Stroke Co-uncil and the Council on Cardiovascular Disease in the Yo-ung. Stroke 2008; 39: 2644-91. 22.Kurnik K, Kosch A, Strater R; Schobess R, et al. Recurrentthromboembolism in infants and children suffering fromsymptomatic neonatal arterial stroke: a prospective follow-up study. Stroke 2003; 34: 2887-92. 23.Govaert P, Matthys E, Zecic A, et al. Perinatal cortical infarc-tion within middle cerebral artery trunks. Arch Dis Child Fe-tal Neonatal Ed 2000; 82: F59-63. 24.Lee J, Croen LA, Lindan C, et al. Predictors of outcome in pe-rinatal arterial stroke: a population based study. Ann Neurol2005; 58: 303. 25.Sreenan C, Bhargava R, Robertson CM. Cerebral infarctionin the term newborn: clinical presentation and long-term out-come. J Pediatr 2000; 137: 351-55. 26.Golomb MR; MacGregor DL, Domi T, et al. Presumed pre-and perinatal arterial ischemic stroke: risk factors and out-comes. Ann Neurol 2001; 50: 163-68. 27.Barron TF, Gusnard DA, Zimmermann RA, Clancy RR. Ce-rebral venous thrombosis in neonates and children. PediatrNeurol 1992; 8: 112-16. 28.Heller C, Heniecke A, Junker R, et al. Cerebral venous throm-bosis in children: a multifactorial origin. Circulation 2003;108: 1362-67. 29.Anstrom JA, Rrown WR, Moody DM, et al. Subependymal ve-ins in premature neonates: implications for hemorrhage. Pe-diatr Neurol 2004; 30: 46-53. 30.Ramenghi LA, Govaert P, Fumagalli M, Bassi L, Mosca F. Neo-natal cerebral sinovenous thrombosis. Semin Fetal NeonatalMed 2009; 14: 278-83. 31.Fitzgerald KC, Willians LS; Garg BP, et al. Cerebral sinove-nous thrombosis in the neonate. Arch Neurol 2006; 63: 405-409. 32.deVeeber G, Chan A, Monagle P, et al. Anticoagulation the-rapy in pediatric patients with sinovenous thrombosis: a co-hort study. Arch Neurol 1998; 55: 1533-37. 33.Monagle P, Cambers E, Chan A, et al. Antithrombotic therapyin neonates and children. Chest 2008; 133: 887S – 968S.

Perinatal İnme

Year 2017, Volume: 9 Issue: 6, 13 - 16, 17.11.2017

Abstract

Öz

Perinatal inme; gebeliğin 20. haftası ile postnatal 28. günler arasında görülen, arteryel veya venöz tromboz veya emboliye bağlı olarak serebral kan akımının bozulduğu, heterojen bir hastalık grubudur. Kanama, perinatal inmede nadirdir ancak serebral sinüs venosus trombozunda bulunabilir. Risk faktörleri arasında hipoksi, hiperkoagübilite endotel hasarı ile infertilite, preeklampsi, trombofili, intrauterin büyüme kısıtlığı, sigara, erken membran rüptürü, maternal ateş ve korioamniyonit yer alır. PI vakalarının büyük kısmı term bebeklerde görülür ve yenidoğan döneminde bulgu verir ancak fokal nörolojik bulgular çok nadirdir. Yenidoğan dönemindeki konvülziyonların, perinatal asfiksiden sonraki en büyük nedeni, perinatal inmedir. Tanıda ultrasonografi veya MRI kullanılır. Fetal ve neonatal inmenin kesin bir tedavisi yoktur. Tedaviler genellikle destekleyici tiptedir. Fetal inmelerin yarısı intrauterin dönemde ölür, ölü doğar veya termine edilir. Doğanların da beşte biri ölür. Kalanların yarısında ise sıklıkla 6 yaşına gelindiğinde sekel bulunduğu belirtilir. Neonatal inme sonrası ölüm çok azdır. Serebral venöz tromboz genetik veya edinsel nedenli olabilir. Genellikle destekleyici tedavi yapılır. Mortalite nadirdir.

References

  • Kaynaklar 1.Raju TN, Nelson KB, Ferriero D, Lynch JK. Ischemic perina-tal stroke: summary of a workshop sponsored by the Natio-nal Institute of Child Health and Human Development and theNational Institute of Neurological Disorders and Stroke. Pe-diatrics 2007; 120: 609-16. 2.Burns CM; Rutherford MA, Boardrman JP, et al. Pattern of ce-rebral injury and neurodevelopmental outcomes after sympto-matic neonatal hypoglycemia. Pediatrics 2008; 122: 65-74. 3.deVries LS, Verboon Maciolek MA, Cowan FM, et al. The roleof cranial ultrasound and magnetic resonance imaging in thediagnosis of infections of the central nervous system. Early HumDev 2006; 82: 819-25. 4.Berfelo FJ, Kersbergen KJ, van Ommen CH, et al. Neonatalcerebral sinovenous thrombosis from symptom to outcome. Stro-ke 2010; 41: 1382-88. 5.Ramenghi LA, Govaert P, Fumagalli M, et al. Neonatal cereb-ral sinovenous thrombosis. Semin Fetal Neonatal Med 2009;14: 278-83. 6.Rutherford MA, Ramengni LA, Cowan FM. Neonatal stroke.Arch Dis Child Fetal Neonatal Ed 2012; 97: F377-F384. 7.Levine D. Case 46: Encephalomalacia in surviving twin afterdeath of monochorionic co-twin. Radiology 2002; 223: 392-95. 8.Özduman K, deVeber G, Ment LR. Stroke in the fetus and neona-te. In: Perlman JM, ed. Neurology: Neonatology Questions andControversies. Philadelphia: Saunders-Elsevier, 2008: 88-121. 9.Dale ST, Coleman LT. Neonatal alloimmune thrombocytope-nia: Antenatal and postnatal imaging findings in the pediat-ric brain. Am J Neuroradiol 2002; 23: 1457-65. 10.Pineda M, Campistol J, Vilaseca MA, et al. An atypical French formof pyruvate carboxylase deficiency. Brain Dev 1995; 12: 276-79. 11.Günther G, Junker R, Strater R, et al. Symptomatic ischemicstroke in full term neonates: role of acquired and genetic proth-rombotic risk factors. Stroke 2000; 31: 2437-41. 12.Miller SP, McQuillen PS, Hamrick S, et al. Abnormal braindevelopment in newborns with congenital heart disease. N EnglJ Med 2007; 357: 1928-38. 13.Miller V. Neonatal cerebral infarction. Semin Pediatr Neurol2000; 7: 278-88. 14.deVries LS; Groenendaal F, Eken P, et al. Infarcts in the vas-cular distribution of the middle cerebral artery in preterm andfull-term infant. Neuropediatrics 1997; 28: 88-96. 15.Perlman JM, Rollins NK; Evans D. Neonatal stroke: clinicalcharacteristics and cerebral blood flow velocity measurement.Pediatr Neurol 1994; 11: 281-84. 16.Uvebrant P. Hemiplegic cerebral palsy. Aetiology and outco-me. Acta Paediatr Scand Suppl 1988; 345: 1-100. 17.Estan J, Hope P. Unilateral neonatal cerebral infarction in full terminfants. Arch Dis Child Fetal Neonatal Ed 1997; 76: F88-93. 18.Lehman LL, Rivkin MJ. Perinatal arterial ischemic stroke: pre-sentation, risk factors, evaluation, and outcome. Pediatr Neu-rol 2014; 51: 760-68. 19.Lee J, Croen LA, Lindan C, et al. Predictors of outcome in pe-rinatal arterial stroke: a population based study. Ann Neurol2005; 58: 303-308. 20.Guzzetta A, Pecini C, Biagi L, et al. Language organizationin left perinatal stroke. Neuropediatrics 2008; 39: 157-63. 21.Roach ES; Golomb MR, Adams R, et al. Management of stro-ke in infants and children: a scientific statement from a Spe-cial Writing Group of American Heart Association Stroke Co-uncil and the Council on Cardiovascular Disease in the Yo-ung. Stroke 2008; 39: 2644-91. 22.Kurnik K, Kosch A, Strater R; Schobess R, et al. Recurrentthromboembolism in infants and children suffering fromsymptomatic neonatal arterial stroke: a prospective follow-up study. Stroke 2003; 34: 2887-92. 23.Govaert P, Matthys E, Zecic A, et al. Perinatal cortical infarc-tion within middle cerebral artery trunks. Arch Dis Child Fe-tal Neonatal Ed 2000; 82: F59-63. 24.Lee J, Croen LA, Lindan C, et al. Predictors of outcome in pe-rinatal arterial stroke: a population based study. Ann Neurol2005; 58: 303. 25.Sreenan C, Bhargava R, Robertson CM. Cerebral infarctionin the term newborn: clinical presentation and long-term out-come. J Pediatr 2000; 137: 351-55. 26.Golomb MR; MacGregor DL, Domi T, et al. Presumed pre-and perinatal arterial ischemic stroke: risk factors and out-comes. Ann Neurol 2001; 50: 163-68. 27.Barron TF, Gusnard DA, Zimmermann RA, Clancy RR. Ce-rebral venous thrombosis in neonates and children. PediatrNeurol 1992; 8: 112-16. 28.Heller C, Heniecke A, Junker R, et al. Cerebral venous throm-bosis in children: a multifactorial origin. Circulation 2003;108: 1362-67. 29.Anstrom JA, Rrown WR, Moody DM, et al. Subependymal ve-ins in premature neonates: implications for hemorrhage. Pe-diatr Neurol 2004; 30: 46-53. 30.Ramenghi LA, Govaert P, Fumagalli M, Bassi L, Mosca F. Neo-natal cerebral sinovenous thrombosis. Semin Fetal NeonatalMed 2009; 14: 278-83. 31.Fitzgerald KC, Willians LS; Garg BP, et al. Cerebral sinove-nous thrombosis in the neonate. Arch Neurol 2006; 63: 405-409. 32.deVeeber G, Chan A, Monagle P, et al. Anticoagulation the-rapy in pediatric patients with sinovenous thrombosis: a co-hort study. Arch Neurol 1998; 55: 1533-37. 33.Monagle P, Cambers E, Chan A, et al. Antithrombotic therapyin neonates and children. Chest 2008; 133: 887S – 968S.
There are 1 citations in total.

Details

Primary Language Turkish
Journal Section makale
Authors

Prof. Dr. Fahri Ovalı

Publication Date November 17, 2017
Published in Issue Year 2017 Volume: 9 Issue: 6

Cite

APA Ovalı, P. D. F. (2017). Perinatal İnme. Klinik Tıp Pediatri Dergisi, 9(6), 13-16.
AMA Ovalı PDF. Perinatal İnme. Pediatri. November 2017;9(6):13-16.
Chicago Ovalı, Prof. Dr. Fahri. “Perinatal İnme”. Klinik Tıp Pediatri Dergisi 9, no. 6 (November 2017): 13-16.
EndNote Ovalı PDF (November 1, 2017) Perinatal İnme. Klinik Tıp Pediatri Dergisi 9 6 13–16.
IEEE P. D. F. Ovalı, “Perinatal İnme”, Pediatri, vol. 9, no. 6, pp. 13–16, 2017.
ISNAD Ovalı, Prof. Dr. Fahri. “Perinatal İnme”. Klinik Tıp Pediatri Dergisi 9/6 (November 2017), 13-16.
JAMA Ovalı PDF. Perinatal İnme. Pediatri. 2017;9:13–16.
MLA Ovalı, Prof. Dr. Fahri. “Perinatal İnme”. Klinik Tıp Pediatri Dergisi, vol. 9, no. 6, 2017, pp. 13-16.
Vancouver Ovalı PDF. Perinatal İnme. Pediatri. 2017;9(6):13-6.