Fetal and neonatal cerebral infarcts

Focal arterial infarction in the full-term newborn is an important cause of acquired cerebral lesions in the perinatal period. Clinical motor seizures , most often unifocal, are the nearly constant disclosing symptom confirmed by focal EEG abnormalities. A multifactorial physiopathology is usual, inc luding genetic and perinatal environmental factors. In the past decade, var ious acquired or genetic thrombophilias have been discussed as risk factors . For several of the involved mechanisms, the excitotoxic cascade could rep resent a common final pathway leading to neuronal cell death. Early magneti c resonance imaging studies and EEG help to identify the newborns with stro kes who are likely to develop hemiplegia and disabilities at school. Protec tion of the human fetal brain remains difficult, since the triggering facto r initiating the excitotoxic cascade is rarely observed. Treatment of seizu res is nevertheless necessary, because it seems that they accelerate anoxia -induced neuronal death in animal models of focal hypoxic ischemia. Copyrig ht (C) 2001 S. Karger AG. Basel.