Perinatal Stroke

Yıl 2017, Cilt: 9 Sayı: 6, 13 - 16, 17.11.2017

Prof. Dr. Fahri Ovalı

Öz

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.

Anahtar Kelimeler

Stroke, neonate, perinatal

Perinatal İnme

Öz

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.

Anahtar Kelimeler

İnme, yenidoğan, perinatal

Kaynakça

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