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Article type: Case Report
Authors: Suppiej, A.a; b; * | Toffoli, E.b | Festa, I.b | Cervesi, C.b | Cappellari, A.b | Manara, R.c | Magarotto, M.d | Cainelli, E.b
Affiliations: [a] Department of Medical Sciences, Pediatric Section, University of Ferrara, Ferrara, Italy | [b] Child Neurology and Clinical Neurophysiology, Pediatric University Hospital, Padua, Italy | [c] Department of Neurosciences, Neuroradiology Unit, University of Salerno, Salerno, Italy | [d] Neonatal Intensive Care Unit, Pediatric University Hospital, Padua, Italy
Correspondence: [*] Address for correspondence: Agnese Suppiej, M.D., Department of Medical Sciences, Pediatric Section, University of Ferrara, Via Aldo Moro, 8, 44124 Ferrara, Italy. Tel.: +39 0039 3473677013; Fax: +39 0532 23 78 48; E-mail: agnese.suppiej@unife.it.
Abstract: The mechanisms of perinatal stroke are poorly understood but preclinical studies point to the crucial role of perinatal inflammation. Carotid artery occlusion represents a very rare and severe cause of perinatal stroke. We describe two cases diagnosed with extensive ischemic stroke due to carotid artery occlusion. In both cases, we demonstrated placental vasculopathy. High levels of C-reactive protein in mother and/or neonates suggested inflammatory mechanism as a potential trigger. Both cases underwent hypothermic treatment without complications because of initial diagnosis of perinatal asphyxia. The prognosis at the time of the last follow up was severe including cerebral palsy, epilepsy and cognitive impairment. Our cases contribute to the actual debate on pathogenic mechanisms and treatment options for this rare condition.
Keywords: Neonate, inflammation, hypothermia, thrombophilia, seizures, outcome
DOI: 10.3233/NPM-1816
Journal: Journal of Neonatal-Perinatal Medicine, vol. 12, no. 4, pp. 479-485, 2019
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