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Neonatal Stroke — RACP Paediatrics MCQ

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HardNeurology & DevelopmentNeonatal StrokeRACP Paediatrics

A term neonate develops seizures at 12 hours of age. MRI brain shows restricted diffusion in the left middle cerebral artery territory. The pregnancy and delivery were unremarkable. What is the most likely diagnosis?

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Correct answer: D — Neonatal arterial ischaemic stroke

Focal seizures presenting within the first 72 hours of life, with MRI showing restricted diffusion in a single arterial territory, are characteristic of perinatal arterial ischaemic stroke. This occurs in approximately 1 in 2300–5000 live births. Investigations should include a thrombophilia screen, echocardiography, and cranial imaging. Long-term neurodevelopmental follow-up is essential.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Neonatal Seizures