Department of Pediatrics, Seoul National University College of Medicine, Seoul, Korea.
J Korean Med Sci. 2010 Jun;25(6):888-94. doi: 10.3346/jkms.2010.25.6.888. Epub 2010 May 24.
Perinatal stroke in neonates can lead to disability in later life. However, its etiology and prognosis are poorly understood. The aim of this study was to describe clinical presentations and neurodevelopmental outcomes of our case series of perinatal stroke in Korea. Thirteen term and preterm neonates who were diagnosed with perinatal stroke in two university hospitals from March 2003 to March 2007 were enrolled. Seven term and 6 preterm neonates were diagnosed with perinatal stroke, based on the brain MRI findings. Perinatal stroke presented with seizure (4/13), perinatal distress (3/13) in term neonates, whereas stroke in preterm neonates did not present with noticeable clinical symptoms. Only one neonate had positive thrombophilic test (homozygous C677T polymorphism for MTHFR). Ten neonates had infarctions in the territory of the middle cerebral artery (MCA), and 3 neonates had borderzone infarctions between the anterior cerebral artery and MCA. Neurodevelopmental outcome was abnormal in 4 neonates. Infarction in MCA main branch or posterior limb of internal capsule showed an abnormal neurodevelopmental outcome. Our study is the first systematic study of perinatal stroke in Korea, and shows its clinical presentations and neurodevelopmental outcomes. The population-based study on incidence and prognosis of perinatal stroke in Korea is required in the future.
围产期脑卒中可导致新生儿日后残疾。但其病因和预后仍不清楚。本研究旨在描述韩国围产期脑卒中病例系列的临床表现和神经发育结局。2003 年 3 月至 2007 年 3 月，两所大学医院共收治了 13 例胎龄和早产儿围产期脑卒中患儿。7 例足月儿和 6 例早产儿根据脑部 MRI 结果诊断为围产期脑卒中。围产期脑卒中在足月儿中表现为癫痫发作（4/13）和围产期窘迫（3/13），而早产儿中则没有明显的临床症状。仅有 1 例新生儿存在阳性血栓形成倾向试验（MTHFR 的 C677T 纯合子多态性）。10 例新生儿大脑中动脉（MCA）区域梗死，3 例新生儿大脑前动脉和 MCA 之间交界区梗死。4 例新生儿神经发育异常。MCA 主干或内囊后肢梗死表现为异常神经发育结局。本研究是韩国围产期脑卒中的首次系统研究，显示了其临床表现和神经发育结局。未来需要在韩国进行围产期脑卒中发病率和预后的基于人群的研究。
