The presentation, EEG, imaging studies, and outcome of six term neonates with middle cerebral artery infarcts are reported from Mannheim Hospital, University of Heidelberg, Germany. Birth was by cesarean section in 5 cases. Apgars were normal in 4. Seizures occurred in 4 within 1 to 3 days and in 2 at the 5th and 9th days. EEGs showed focal slowing followed by focal spike-wave activity, correlating with the structural lesion defined by neuroimaging. EEG abnormalities sometimes antedated a positive ultrasound. A late intra-uterine event was suggested. Only 2 had obvious hemiparesis at discharge, but all children showed developmental delay and spastic hemiparesis at 3 to 10 year follow up. One had infantile spasms and hemihypsarrhythmia, relieved only after drainage of a cyst and shunt procedure. Four developed epilepsy late. [1]
COMMENT. This study confirms previous reports of late onset of epilepsy and development of spastic hemiparesis and cognitive deficits following an apparent early favorable outcome in term neonates suffering middle cerebral artery infarcts.
LATE PROGRESSIVE THALAMIC ATROPHY in four children with neonatal middle cerebral artery infarction is reported from the Centre Hospitalo-Universitaire, Dijon, France. [2]