Stroke in neonates.

Five neonates with large cerebral infarctions of arterial origin are presented. Four had severe focal seizures on the first day of life. The fifth, a premature infant, was asymptomatic. The diagnoses were made by computed tomography (CT) scans between 5 and 12 days of life; CT scans obtained in the first few days of life were normal. In the fifth infant, the infarct was hemorrhagic and was also noted by cranial ultrasound. Three of the infants had a history of trauma to the head or neck during labor and birth. Only one was severely asphyxiated at birth. Two apparently are doing well at 1 year of age. Cerebral infarcts of arterial origin in neonates probably have been missed in living patients in the past, but now are recognized in the newborn period by properly timed CT examination.