The clinical outcome of 17 children, 1 to 11 years of age, who experienced cerebral artery infarctions as neonates has been studied in the Depts of Pediatrics and Neurology, Univ of Kentucky Med Center, Lexington, Kentucky. The left middle cerebral artery (MCA) was involved in 9 (53%) and the right MCA in 5 (30%). Fourteen (82%) who developed neonatal seizures became seizure free and neurologically normal within the first year and anticonvulsants were discontinued. Three patients had recurrence of seizures after 1 to 8 years and anticonvulsants were renewed. Eleven patients (65%) have normal neurologic development but one of 2 attending school has cognitive deficits. [1]
COMMENT. The authors conclude that infants with a unilateral arterial stroke generally have a favorable prognosis initially but require long-term follow up for possible recurrence of seizures and development of learning disabilities. Comparing these results with a previous report of neonatal stroke (See Ped Neur Briefs Aug 1988;2: 63-64 ), the increased prevalence of left middle cerebral artery infarction and the frequent complication of neonatal seizures are in agreement, but the recovery of neurologic function within 1 year is in contrast to a persistent hemiparesis in 66% of patients examined at 1-4 years of age.