Neonatal Stroke
Neurological Disorders in Newborns, NOVA Publications , ss.129-138, 2025
- Yayın Türü: Kitapta Bölüm / Araştırma Kitabı
- Basım Tarihi: 2025
- Yayınevi: NOVA Publications
- Sayfa Sayıları: ss.129-138
- Anahtar Kelimeler: Epilepsy, Infarct, Rehabilitation, Stroke, Thrombus
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Neonatal stroke is a thrombotic obstruction occurring in the perinatal period. After hypoxic ischaemic encephalopathy, it is the second most common cause of seizure in the first 72 hours in newborns. The clinical presentation is in the form of acute or presumed/late stroke, depending on the time. Just as there may be arterial or venous involvement, the involvement type may be hemorrhagic, ischaemic, or the two together. The most frequently seen is neonatal arterial ischaemic stroke, involving the left middle cerebral artery. In venous involvement, cerebral sinovenous thrombosis should come to mind, especially in term infants with intraventricular hemorrhage or thalamus hemorrhage. Although the first stage in diagnosis is cranial ultrasonography, definitive diagnosis is made from diffusion MRI and MR angiography. Seizure control and supportive treatment are applied in the first stage of treatment. The only stroke for which anticoagulants are administered is cerebral sinovenous thrombosis. Motor involvement is greater in arterial strokes in particular. The prognosis for total middle cerebral artery involvement is poor and this may lead to hemiparetic cerebral palsy. The upper extremities are most involved, and epilepsy is seen in 15-40% of survivors. Although speech development is generally protected, learning difficulties together with behavioural and adaptation problems may be seen in the school years. By starting rehabilitation early, positive results can be obtained through physiotherapy and ergotherapy due to the neuroplasticity of the developing brain.