Neonatal stroke and intracranial haemorrhage

Overview & Definition

A neonate who presents with a focal seizure, hand-preference, or unexplained encephalopathy may have sustained a cerebrovascular injury around the time of birth. The 2007 NICHD-NINDS workshop defined perinatal stroke as a group of cerebrovascular events occurring between 20 weeks of fetal life and 28 days postnatal, and it distinguished several distinct entities that share a narrow time window but differ in mechanism, vessel involvement, and outcome. ^[1]

Perinatal arterial ischaemic stroke (PAIS) is a focal arterial infarction of the brain confirmed by neuroimaging, occurring in the perinatal period and producing a focal neurological deficit or seizures. Cerebral sinovenous thrombosis (CSVT) is thrombosis of the cerebral venous sinuses or deep veins. Neonatal haemorrhagic stroke is a non-traumatic, intracranial haemorrhage — subdural, subarachnoid, parenchymal or intraventricular — that produces acute neurological dysfunction. ^{[1] [2]}

In the preterm infant, the dominant cerebrovascular lesion is germinal matrix-intraventricular haemorrhage (GMH-IVH), originating in the fragile capillary bed of the subependymal germinal matrix, with potential extension into the ventricle and the periventricular white matter. This entity, graded by the Papile system, carries its own pathophysiology and its own principal complication — post-haemorrhagic ventricular dilation (PHVD). ^{[4] [5]}

References9ShowHide

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