European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society · 2025
Reevaluating isolated central apnea in early-term and term newborns: A neurological red flag for perinatal stroke.
СтатьяНазвание и аннотация: Перевод в очереди
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Calandrino Andrea, Battaglini Marcella, Caruggi Samuele, Bonato Irene, Massirio Paolo, Andreato Chiara, Vinci Francesco, Malova Mariya, Bertamino Marta, Amadori Elisabetta, Uccella Sara, Resaz Martina, Severino Mariasavina, Rossi Andrea, Striano Pasquale, Ramenghi Luca Antonio
Аннотация
INTRODUCTION: Seizures are the most frequent initial symptom of perinatal stroke. Apnea, a less commonly recognized neurological presentation, is a cessation of breathing lasting >15 s or shorter if associated with bradycardia. This study explores a monocentric cohort of newborns with perinatal stroke, emphasizing the role of Isolated Central Apnea (ICA) as a potential early indicator of cerebrovascular insult.
METHODS: A retrospective review was conducted on newborns (≥36 weeks GA) diagnosed with MRI-confirmed perinatal stroke at our institution between March 2019 and March 2024. Infants with hypoxic-ischemic encephalopathy (HIE), congenital infections, meningoencephalitis, sepsis, or intrauterine stroke were excluded. Clinical data, neuroimaging findings, EEG/aEEG characteristics, and antiepileptic drug (AED) were analyzed.
RESULTS: Of 421 newborns who underwent brain MRI, 27 (6 %) were diagnosed with perinatal stroke (16 males; median GA 38.5 weeks; mean BW 3137g). Seizures were the presenting symptom in 18 cases (67 %), while 8 cases (30 %) exhibited ICA as the first sign and an MRI revealing 5 arterial strokes (63 %) and 3 venous strokes (37 %). EEG abnormalities were detected in 7/8 (88 %) cases, while brain ultrasound was abnormal in 5/8 (63 %). AED therapy was required in 7/8 (88 %) patients.
CONCLUSIONS: ICA is an early sign of neonatal stroke in approximately one-third of cases. These findings underscore the importance of brain MRI in the diagnostic workup of persistent apnea in term and early-term neonates.
METHODS: A retrospective review was conducted on newborns (≥36 weeks GA) diagnosed with MRI-confirmed perinatal stroke at our institution between March 2019 and March 2024. Infants with hypoxic-ischemic encephalopathy (HIE), congenital infections, meningoencephalitis, sepsis, or intrauterine stroke were excluded. Clinical data, neuroimaging findings, EEG/aEEG characteristics, and antiepileptic drug (AED) were analyzed.
RESULTS: Of 421 newborns who underwent brain MRI, 27 (6 %) were diagnosed with perinatal stroke (16 males; median GA 38.5 weeks; mean BW 3137g). Seizures were the presenting symptom in 18 cases (67 %), while 8 cases (30 %) exhibited ICA as the first sign and an MRI revealing 5 arterial strokes (63 %) and 3 venous strokes (37 %). EEG abnormalities were detected in 7/8 (88 %) cases, while brain ultrasound was abnormal in 5/8 (63 %). AED therapy was required in 7/8 (88 %) patients.
CONCLUSIONS: ICA is an early sign of neonatal stroke in approximately one-third of cases. These findings underscore the importance of brain MRI in the diagnostic workup of persistent apnea in term and early-term neonates.