围产期动脉缺血性卒中的诊断与急性处理
Diagnosis and acute management of perinatal arterial ischemic stroke.
作者信息
Armstrong-Wells Jennifer, Ferriero Donna M
机构信息
Departments of Pediatrics (Neurology) and OB/GYN (JA-W), University of Colorado School of Medicine, Aurora; and the University of California San Francisco Benioff Children's Hospital and Departments of Pediatrics and Neurology (DMF), University of California San Francisco.
出版信息
Neurol Clin Pract. 2014 Oct;4(5):378-385. doi: 10.1212/CPJ.0000000000000077.
Abstract
Perinatal arterial ischemic stroke (PAIS) can be an unrecognized cause of short- and long-term neurologic disability. Focal clonic seizure in the newborn period is the most common clinical presentation of PAIS. MRI is optimal in diagnosing PAIS; negative cranial ultrasound or CT does not rule out PAIS. Given the low rate of recurrence in combination with risk factors thought to be isolated to the maternal-fetal unit, anticoagulation or antiplatelet treatment is usually not recommended. The majority of newborns with PAIS do not go on to develop epilepsy, although further research is warranted in this area. Long-term morbidity, including motor, cognitive, and behavioral disabilities, can follow PAIS, necessitating early recognition, diagnosis, and therapy initiation.
摘要
围产期动脉缺血性卒中（PAIS）可能是短期和长期神经功能残疾的一个未被认识的原因。新生儿期局灶性阵挛性发作是PAIS最常见的临床表现。MRI是诊断PAIS的最佳方法；头颅超声或CT阴性不能排除PAIS。鉴于复发率低，且认为危险因素仅限于母胎单位，通常不建议进行抗凝或抗血小板治疗。大多数患有PAIS的新生儿不会发展为癫痫，尽管这一领域有必要进行进一步研究。PAIS之后可能会出现包括运动、认知和行为残疾在内的长期发病率，因此需要早期识别、诊断和开始治疗。
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