Neonatal stroke and intracranial haemorrhage — structured clinical encounter

Station brief (candidate)

You are the neonatal registrar. A term infant (39 weeks, birthweight 3400 g) born by emergency caesarean for failure to progress after an instrumental attempt is reviewed at 30 hours of age for rhythmic jerking of the right arm and right side of the face. Between events the infant is alert but has asymmetric tone and a reduced grasp on the right. Blood glucose is 3.2 mmol/L. Cranial ultrasound on day 2 is reported as normal. The team asks you to establish the diagnosis, the imaging plan, and the management and prognostic pathway. You have 12 minutes with the team and 5 minutes for examiner discussion. [9]