The role of ultrasound in the early diagnosis of perinatal ischemic strokes. The possibility of duplex scanning in determination of the affected vascular region

Abstract

Ultrasound methods play an essential role in the early diagnostics of perinatal ischemic strokes, help to identify ischemic foci of the different localization, sizes, and blood flow in the affected vascular pool.

The analysis of ultrasound and clinical data indicates that antenatal and postnatal ischemic stroke have significant differences. Antenatal strokes develop before the delivery is usually localized in the pool of lenticularstriar arteries, and not accompanied by focal neurological symptoms.

Postnatal strokes will happen mostly on the 2nd-3rd day of life and manifested by focal neurological symptoms. They localized in the cortical-subcortical region. Foci of ischemia more visible by ultrasound only at the end of the second day of the disease. Local blood flow disorders in the affected vascular pool detected by duplex scanning from the first day of the disease.

Keywords:newborns, perinatal ischemic strokes, ultrasound diagnostics

Funding. The study had no sponsor support.

Conflict of interests. The authors declare no conflict of interests.

For citation: Bykova Yu.K., Ushakova L.V., Filippova E.A., Vatolin K.V., Sugak A.B., Amirkhanova D.Yu., Bychenko V.G., Zubkov V.V. The role of ultrasound in the early diagnosis of perinatal ischemic strokes. The possibility of duplex scanning in determination of the affected vascular region. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2020; 8 (1): 72-82. doi: 10.33029/2308-2402-2020-8-1-72-82 (in Russian)

References

1. Olive G., Agut T., Echeverria-Palacio C.M., Arca G., Garcfa-Alix A. Usefulness of cranial ultrasound for detecting neonatal middle cerebral artery stroke. Ultrasound Med Biol. 2019; 45 (3): 885-90. DOI: 10.1016/j.ultrasmedbio.2018.11.004.

2. Saliba E., Debillon T., Auvin S., Baud O., Biran V., Chabernaud J.L., et al.; Recommandations accident vasculaire cerebral (AVC) neonatal. Neonatal arterial ischemic stroke: review of the current guidelines. Arch Pediatr. 2017; 24 (2): 180-8. DOI: 10.1016/j.arcped.2016.11.005.

3. Husson B., Durand C., Hertz-Pannier L. Recommendations for imaging neonatal ischemic stroke. Arch Pediatr. 2017; 24 (9S): 9S19-27. DOI: 10.1016/S0929-693X(17)30327-5.

4. Deeg K.H. Sonographic and Doppler sonographic diagnosis of neonatal ischemic stroke.Ultraschall Med. 2017; 38 (4): 360-76. DOI: 10.1055/s-0043-114409.

5. Martinez-Biarge M., Ferriero D.M., Cowan F.M. Perinatal arterial ischemic stroke. In: Handbook of Clinical Neurology. 2019; 162: 239-66.

6. An Atlas of Neonatal Brain Sonography. 2nd ed. In: Govaert P., De Vries L.S. Mac Keith Press, 2010: 419 p.

7. Ushakova L.V., Bykova Yu.K., Bychenko V.G., Filippova E.A., Strutin-skaya A.D. Clinical and diagnostic criteria for perinatal arterial ischemic stroke in children. Neonatologiya: novosti, mneniya, obuchenie [Neonatology: News, Opinions, Training]. 2017; (4): 104-12. (in Russian)

8. Narogan M.V., Bychenko V.G., Ushakova L.V., Amirkhanova D.Yu., Ryumina I.I., Artamkina E.I., et al. Perinatal arterial ischemic stroke: frequency, diagnosis, variants of clinical course, early outcomes. Pediatriya. Zhurnal im. G.N. Speranskogo [Pediatrics Journal named after G.N. Speranskiy]. 2019; 98 (2): 35-42. (in Russian)

9. Raju T.N., Nelson K.B., Ferriero D., Lynch J.K. Ischemic perinatal stroke: summary of a workshop sponsored by the National Institute of Child Health and Human Development and the National Institute of Neurological Disorders and Stroke. Pediatrics. 2007; 120: 609-16. DOI: 10.1542/peds.2007-0336.

10. Lynch J.K. Epidemiology and classification of perinatal stroke. Semin Fetal Neonatal Med. 2009; 14: 245-9. DOI: 10.1016/j.siny.2009.07.001.

11. Grunt S., Mazenauer L., Buerki S.E., Boltshauser E., et al. Incidence and outcomes of symptomatic neonatal arterial ischemic stroke. Pediatrics. 2015; 135: e1220-8. DOI: 10.1542/peds.2014-1520.

12. Kirton A., Armstrong-Wells J., Chang T., Deveber G., et al.; International Pediatric Stroke Study Investigators. Symptomatic neonatal arterial ischemic stroke: the international pediatric stroke study. Pediatrics. 2011; 128: e1402-10. DOI: 10.1542/peds.2011-1148.

13. Gunny R.S., Lin D. Imaging of perinatal stroke. Magn Reson Imaging Clin N Am. 2012; 20: 1-33. DOI: 10.1016/j.mric.2011.10.001.

14. Hamid I.S., Mueed Z.A. Perinatal arterial ischaemic stroke: an update with literature review. J Pak Med Assoc. 2008; 58 (7): 395-9.

15. Badve C.A., Khanna P.C., Ishak G.E. Neonatal ischemic brain injury: what every radiologist needs to know. Pediatr Radiol. 2012; 42: 60619. DOI: 10.1007/s00247-011-2332-8.

16. Kirton A., deVeber G. Advances in perinatal ischemic stroke. Pediatr Neurol. 2009; 40: 205-14. DOI: 10.1016/j.pediatrneurol.2008.09.018.

17. Armstrong-Wells J., Ferriero D.M. Diagnosis and acute management of perinatal arterial ischemic stroke. Neurol Clin Pract. 2014; 4: 37885. DOI: 10.1212/CPJ.0000000000000077.

18. Sehgal A. Perinatal stroke: a case-based review. Eur J Pediatr. 2012; 171: 225-34. DOI: 10.1007/s00431-011-1509-3.

19. Lee S., Mirsky D.M., Beslow L.A. Pathways for neuroimaging of neonatal stroke. Pediatr Neurol. 2017; 69: 37-48. DOI: 10.1016/j.pediatrneurol.2016.12.008.

20. Fernandez-Lopez D., Natarajan N, Ashwal S. Mechanisms of perinatal arterial ischemic stroke. J Cereb Blood Flow Metab. 2014; 34: 92132. DOI: 10.1038/jcbfm.2014.41.

21. Ilves P., Laugesaar R., Loorits D., Kolk A., et al. Perinatal stroke: risk factors, clinical and radiological findings presumed. J Child Neurol. 2016; 31 (5): 621-9. DOI: 10.1177/0883073815609149.

22. Lehman L.L., Rivkin R.J. Perinatal arterial ischemic stroke: presentation, risk factors, evaluation, and outcome. Pediatr Neurol. 2014; 51: 760-8. DOI: 10.1016/j.pediatrneurol.2014.07.031.

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CHIEF EDITOR
CHIEF EDITOR
Degtyarev Dmitriy Nikolaevich
Doctor of Medical Sciences, Professor, Deputy Director for Scientific Research of the V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Head of the Chair of Neonatology at the Clinical Institute of Children's Health named after N.F. Filatov, I.M. Sechenov First Moscow State Medical University, Chairman of the Ethics Committee of the Russian Society of Neonatologists, Moscow, Russian Federation

ORCID iD 0000-0001-8975-2425

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