Trunkal middle cerebral artery infarction
| Case No | Gestational age | Clinical details | Site | Outcome |
|---|---|---|---|---|
| Entire posterior trunk of the middle cerebral artery | ||||
| 1 | 36 | PROM for 3 days, congenital pneumonia due to early onset group B streptococcal infection, shock | Left | Mild hemisyndrome |
| 2 | 39 | Vacuum extraction, cephalhaematoma, focal seizures on day 1, early onset enterobacter septicaemia, no shock | Left | No sequelae |
| 3 | 38 | Second twin, cord prolapse, difficult vacuum delivery, subgaleal bleeding, basal subdural haematoma, focal EEG changes | Left | Mild hemisyndrome |
| 4 | 40 | PROM for 3 days, vacuum delivery, Apgar scores 4/6, general seizures on day 1, day 1 Hb 10.2 g/dl, metabolic acidosis | Left | Mild hemisyndrome, speech difficulties |
| 5 (fig 1) | 37 | Twin, left renal vein thrombosis and adrenal haemorrhage, apc resistance | Right | No sequelae |
| 6 | 38 | Breech delivery, focal seizures on day 2 | Left | One epileptic insult at 3 months, no hemisyndrome |
| 7 | 33 | Caesarean section for fetal distress superimposed on growth retardation; no IRDS; APC resistance; early cystic stage of the haemorrhagic infarction on day 1 | Left | No follow up |
| Entire anterior trunk of the middle cerebral artery | ||||
| 8 (fig2) | 34 | IUGR, lost beat to beat variation, brief postnatal acidosis (the area involved span the right frontal and part of the parietal lobe's convexity, including rolandic cortex) | Right | Severe hemiplegia, MDI 84 |
| 9 | 40 | Focal seizures on day 2, APC resistance in propositus and asymptomatic father (presentation was with a right frontal lobe haematoma; the evolution showed this to be infarction with late neonatal regression with multiple cysts) | Right | Normal at 12 months, right predominance |
| Within part of the anterior trunk of the middle cerebral artery | ||||
| 10 | 30 | Death of co-twin at 26 weeks, IRDS (the affected vessel was probably a branch of the prefrontal artery) | Right | Unknown |
| 11 | 38 | Second day seizures in a healthy infant | Left | Unknown |
| 12 | 38 | Coarctation aorta, oesophageal atresia; systemic acidosis (haemorrhagic leucomalacia and right anterior middle cerebral artery infarction were associated in this child) | Right | Unknown |
| 13 | 40 | Oligohydramnios and stunted fetal growth for 2 weeks, chronic fetomaternal transfusion (Kleihauer-Betke 6%), focal seizures on day 2 (the area involved may have been within the prefrontal and precentral branches of the middle cerebral artery or may have been a watershed zone with the anterior cerebral artery) | Right | Normal at 12 months |
Key: PROM = Premature rupture of membrane; IRDS = Idiopathic respiratory distress syndrome; APC = Activated protein C resistance (factor V Leiden).