Ozduman Koray, Pober Barbara R, Barnes Patrick, Copel Joshua A, Ogle Eileen A, Duncan Charles C, Ment Laura R
Department of Radiology, Stanford University School of Medicine, Stanford, California, USA.
Pediatr Neurol. 2004 Mar;30(3):151-62. doi: 10.1016/j.pediatrneurol.2003.08.004.
Fetal stroke, or that which occurs between 14 weeks of gestation and the onset of labor resulting in delivery, has been associated with postnatal epilepsy, mental retardation, and cerebral palsy. The entity is caused by antenatal ischemic, thrombotic, or hemorrhagic injury. We present seven new cases of fetal stroke diagnosed in utero and review the 47 cases reported in the literature. Although risk factors could not be assigned to 50% of the fetuses with stroke, the most common maternal conditions associated with fetal stroke were alloimmune thrombocytopenia and trauma. Magnetic resonance imaging was optimal for identifying fetal stroke, and prenatal imaging revealed hemorrhagic lesions in over 90% of studies; porencephalies were identified in just 13%. Seventy-eight percent of cases with reported outcome resulted in either death or adverse neurodevelopmental outcome at ages 3 months to 6 years. Fetal stroke appears to have different risk factors, clinical characteristics, and outcomes than other perinatal or childhood stroke syndromes. A better understanding of those risk factors predisposing a fetus to cerebral infarction may provide a basis for future therapeutic intervention trials. Ozduman K, Pober BR, Barnes P, Copel JA, Ogle EA, Duncan CC, Ment LR. Fetal stroke.
胎儿卒中，即发生在妊娠14周与分娩发动之间并导致分娩的卒中，与产后癫痫、智力障碍和脑瘫有关。该病症由产前缺血性、血栓性或出血性损伤引起。我们报告7例产前诊断的胎儿卒中新病例，并回顾文献中报道的47例病例。尽管50%的卒中胎儿无法确定危险因素，但与胎儿卒中相关的最常见母体情况是同种免疫性血小板减少症和创伤。磁共振成像对于识别胎儿卒中最为理想，产前成像显示超过90%的研究中有出血性病变；仅13%的研究中发现了孔洞脑。报告了结局的病例中有78%在3个月至6岁时出现死亡或不良神经发育结局。与其他围产期或儿童期卒中综合征相比，胎儿卒中似乎具有不同的危险因素、临床特征和结局。更好地了解那些使胎儿易患脑梗死的危险因素可能为未来的治疗干预试验提供依据。奥兹杜曼K、波伯BR、巴恩斯P、科佩尔JA、奥格尔EA、邓肯CC、门特LR。胎儿卒中。
