Arch Dis Child Fetal Neonatal Ed 1997;76:F88-F93 ( March )

Unilateral neonatal cerebral infarction in full term infants

Javier Estan, Peter Hope

Department of Paediatrics, John Radcliffe Hospital, Oxford, OX3 9DU

Correspondence to: Dr Peter Hope.

Accepted 11 December 1996

AIMSTo 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.
METHODSTwelve cases of unilateral neonatal cerebral infarction were identified from neonatal unit records for the years 1987-93. Each case was matched with two controls.
RESULTSAll 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.
CONCLUSIONSNeonatal 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.

Keywords: cerebral infarction; seizures; neurodevelopmental outcome; stroke; hemiplegia.

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© 1997 by Archives of Disease in Childhood
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