PROTON MAGNETIC-RESONANCE SPECTROSCOPIC IMAGING IN NEONATAL STROKE

To study cerebral metabolism in neonates after unilateral cerebral inf arcts 4 neonates (3 full-terms, one preterm with a gestational age of 35 weeks) with unilateral cerebral infarcts were examined at 7 to 49 d ays of postnatal age, using proton magnetic resonance spectroscopic im aging (H-1-MRSI). Three neonates had infarcts of the left middle cereb ral artery (MCA), one had a right posterior cerebral artery infarct an d a more localized anterior lesion. Examinations were repeated in the three fullterm infants aged 2-3 months. Lactate resonances, which are not present in normal brain after term age, were demonstrated in two p atients tested at 7 and 10 days of age respectively, and in one of the m lactate was still present at two months. Ln all four neonates a decr ease of the N-acetylaspartate/choline (NAA/Cho) ratio was seen within the area of infarction. Repeated MRS of two infants at three months sh owed an increase in NAA/Cho ratios in all brain areas, but values rema ined below normal in the infarcts. In the third infant a further decre ase in the NAA/Cho ratio was demonstrated in the area of infarction at two months. The NAA/Cho ratios in the surrounding and contralateral b rain tissue were normal in all infants. AU three infants with a MCA in farct developed a hemiplegia. The aforementioned metabolic alterations in neonates with cerebral infarcts, demonstrated using H-1-MRSI, were found to be confined to the area of infarction and abnormalities pers isted beyond the neonatal period.