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Neonatal Arterial Ischaemic Stroke — RACP Paediatrics MCQ

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HardNeonatologyNeonatal Arterial Ischaemic StrokeRACP Paediatrics

A term infant presents with seizures at 18 hours of life. Blood glucose, calcium, and magnesium are normal. Infection screen is negative. MRI shows restricted diffusion in the left middle cerebral artery territory. What is the diagnosis?

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Correct answer: E — Neonatal arterial ischaemic stroke

Neonatal arterial ischaemic stroke presents with focal seizures (often unilateral) in a term neonate. MRI shows acute infarction in an arterial territory (most commonly MCA). Risk factors include perinatal asphyxia, prothrombotic conditions, and congenital heart disease. Anticoagulation is not routinely recommended. Long-term outcomes include hemiplegic CP and epilepsy.

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