Cerebral Infarctions in New-borns and Infants: Early Detection of Risk Factors,
and Sequelae in Neuroevolutionary Development
Rufo Campos Miguel1*, Rufo Muñoz Miguel2 and Rufo Tejeiro Olga3
1Head of the Child Neurology Service. Instituto Hispalense de Pediatría, Seville
2Andalusian Emergency Service, San Isidoro University Center, Seville
3Intensive Care Unit, Virgen del Rocío University Hospital, Seville
*Corresponding Author: Rufo Campos Miguel, Head of the Child Neurology
Service. Instituto Hispalense de Pediatría, Seville.
Received:
March 01, 2022; Published: March 11, 2022
Abstract
Despite the importance of neonatal infarctions, there are very few relative data in our country, both on their frequency, mortality, major risk factors, as well as their important sequelae. In addition, both its pathophysiology and the associated risk factors are not yet clearly understood and defined. Therefore, we tried to establish the percentages of risk, mortality and sequelae of all neonatal strokes that occurred in a large third-level hospital, especially the risk factors that produce it, to try to predict their recurrence.
During a period of 4 years, 53 cases have been collected in which the existence of a recent ischemic-hemorrhagic infarction that occurred during the perinatal period has been demonstrated by neuroimaging a study, making a cut at 30 months of age. Half of the cases were diagnosed within the first month of birth.
The predominance was male and the distribution of cerebral ischemic injury was predominantly of the medial cerebral artery and most often in the left cerebral hemisphere Risk factors were primiparity, fetal death, neonatal sepsis, asphyxia, twin pregnancy, placental abruption, emergency caesarean section, Apgar score ≤7 after 5 min, breech presentation and hyperbilirubinemia. The guiding sign to start the etiological search was the existence of a motor deficit and the presence of epileptic seizures. In much lower proportions psychomotor retardation.
Keywords: Cerebral; Risk Factors; Neuroevolutionary; Sequelae
References
- Dorland’s Illustrated Medical Dicyionary, 26th Philadelphia, WB Saunders 1985;101Jeffrey L Saver. Proposal for a universal definition of cerebral infarction”. Stroke 39.11 (2008): 3110-3115.
- Ferriero DM., et al. American Heart Association Stroke Council and Council on Cardiovascular and Stroke Nursing. “Management of Stroke in Neonates and Children: A Scientific Statement from the American Heart Association/American Stroke Association”. Stroke 3 (2019): e51-e96.
- Radu RA., et al. “Etiologic classification of ischemic stroke: Where do we stand?” Clinical Neurology and Neurosurgery (2017): 93-106.
- Miya E. “Bernson-Leung and Michael J. “Rivkin Stroke in Neonates and Children Pediatrics in Review 37.11 (2016): 463-477.
- Barnette AR and Inder TE. “Evaluation and management of stroke in the neonate”. Clinics in Perinatology 36 (2009): 125-136.
- Mary Dunbar and Adam Kirton. “Perinatal Stroke”. Seminars in Pediatric Neurology 32 (2019): 100767.
- Christerson S and Strömberg B. “Childhood stroke in Sweden I: incidence, symptoms, risk factors and short-term outcome”. Acta Paediatric 11 (2010): 1641-1649.
- Renaud C., et al. “Group. Lipoprotein (a), birth weight and neonatal stroke”. Neonatology3 (2010): 225-228.
- Kenet G., et al. “Impact of thrombophilia on risk of arterial ischemic stroke or cerebral sinovenous thrombosis in neonates and children: a systematic review and meta-analysis of observational studies”. Circulation16 (2010): 1838-1847.
- Curry CJ., et al. “Risk factors for perinatal arterial stroke: a study of 60 mother-child pairs”. Pediatric Neurology 2 (2007): 99-107.
- Simchen MJ., et al. “Factor V Leiden and antiphospholipid antibodies in either mothers or infants increase the risk for perinatal arterial ischemic stroke”. Stroke1 (2009): 65-70.
- Bernard TJ and Goldenberg NA. “Pediatric arterial ischemic stroke”. Hematology/Oncology Clinics of North America 1 (2010): 167-180
- Michoulas A., et al. “The role of hypoxia-ischemia in term newborns with arterial stroke”. Pediatric Neurology 4 (2011): 254-258.
- Mengyu Fan., et al. “Family History, Tobacco Smoking, and Risk of Ischemic Stroke”. Journal of Stroke 2 (2019): 175-183.
- Cnossen MH., et al. “Paediatric arterial ischaemic stroke: functional outcome and risk factors”. Developmental Medicine and Child Neurology 4 (2010): 394-399.
- Cheong JL and Cowan FM. “Neonatal arterial ischaemic stroke: obstetric issues”. Seminars in Fetal and Neonatal Medicine5 (2009): 267-271.
- Khurana DS., et al. “The role of anticoagulation in idiopathic cerebral venous thrombosis”. Journal of Child Neurology 3 (1996): 248-250.
- Odland HH., et al. “Longitudinal myocardial contribution to peak systolic flow and stroke volume in the neonatal heart”. Pediatric Resesarch4 (2011): 345-351.
- Peyvandi S., et al. “Neonatal Brain Injury and Timing of Neurodevelopmental Assessment in Patients with Congenital Heart Disease”. Journal of the American College of Cardiology 18 (2018): 1986-1996.
- Castillo J., et al. “Inflammation markers and prediction of post-stroke vascular disease recurrence: the MITICO study”. Journal of Neurology 256 (2009): 217-224.
- Counsell SJ., et al. “Fetal and neonatal neuroimaging”. Handbook of Clinical Neurology 162 (2019): 67-103.
- Hua F., et al. “Differential roles of TLR2 and TLR4 in acute focal cerebral ischemia/reperfusion injury in mice”. Brain Research 1262 (2009): 100-108.
- Cornette L., et al. “Perinatal stroke”. Seminars in Fetal and Neonatal Medicine 5 (2009): 243-244.
- Caso JR., et al. “Toll-like receptor 4 is involved in subacute stress-induced neuroinflammation and in the worsening of experimental stroke”. Stroke 39 (2008): 1314-1320.
- Cao CX., et al. “Reduced cerebral ischemia-reperfusion injury in Toll-like receptor 4 deficient mice”. Biochemical and Biophysical Research Communications 353 (2007): 509-514.
- Urra X., et al. “Monocytes are major players in the prognosis and risk of infection after acute stroke”. Stroke 40 (2009): 1262-1268.
- Yang QW., et al. “Upregulated expression of toll-like receptor 4 in monocytes correlates with severity of acute cerebral infarction”. Journal of Cerebral Blood Flow and Metabolism 28 (2008): 1588-1596.
- Kirkham FJ., et al. “Risk factors for arterial ischemic stroke in children”. Journal of Child Neurology 15 (2000): 299-307.
- Ganesan V., et al. “Abnormalities of cervical arteries in children with arterial ischemic stroke”. Neurology2 (2011): 166-171.
- Vasudevan C and Levene M. “Epidemiology and aetiology of neonatal seizures”. Seminars in Fetal and Neonatal Medicine 4 (2013): 185-191.
- Dunbar M and Kirton A. “Perinatal Stroke”. Seminars in Pediatric Neurology (2019): 32.
-
Citation
Copyright