Unilateral neonatal cerebral infarction in full term infants
Department of Paediatrics, John Radcliffe Hospital,
Oxford, OX3 9DU
Correspondence to: Dr Peter Hope.
Accepted 11 December 1996
AIMS
To determine the prevalence of unilateral
neonatal cerebral infarction in infants born at 32 weeks gestation and
above; to describe the clinical course, imaging results, and outcome of neonatal cerebral infarction; and to investigate possible aetiology.
METHODS
Twelve cases of unilateral neonatal
cerebral infarction were identified from neonatal unit records for the
years 1987-93. Each case was matched with two controls.
RESULTS
All cases of neonatal cerebral infarction
occurred in full term infants. The prevalence was around 1 in 4000, and
neonatal cerebral infarction was found in 12% of infants presenting
with neonatal seizures. Cerebral ultrasound scans failed to demonstrate lesions seen by computed tomography in nine of 12 cases. Cases were
more likely than controls to require assisted ventilation for
resuscitation at birth (OR 7.0, 95% confidence interval 1.04-53.5), but Apgar scores at 5 minutes were no different. One infant with neonatal cerebral infarction developed a hemiparesis, the other 11 had
normal motor development when assessed at 11-60 (median 33) months.
None had overt cognitive deficits or persisting seizure disorder.
CONCLUSIONS
Neonatal cerebral infarction is
a relatively common cause of neonatal seizures, but the aetiology
remains unclear. Parents need to be made aware of possible neurological
sequelae, but most cases in this series had a normal outcome.
© 1997 by Archives of Disease in Childhood
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