PDF(Pubmed)
Abstract：
Carotid artery dissection is an infrequent cause of neonatal-perinatal stroke. Its rarity may be due to underdiagnosis or lack of awareness. We report a case of a full-term, large-for-gestational-age (LGA) male infant delivered at 39 weeks gestation. Pertinent prenatal and perinatal history include gestational diabetes, preeclampsia, and the use of forceps to assist in delivery due to shoulder dystocia. The infant presented with apnea and cyanosis while rooming which prompted admission to the neonatal intensive care unit (NICU). Initial sonographic investigation revealed an infarct, subsequently confirmed as a massive left-sided infarct by magnetic resonance imaging (MRI) of the brain. Further, computerized tomography (CT) angiography confirmed a dissection in the right common and internal carotid arteries. The child was treated with antiepileptic and antithrombotic medications. He is now undergoing regular neurodevelopmental monitoring and rehabilitation. As per our sources, this case is the first to report a contralateral significant perinatal stroke due to carotid artery dissection. It underscores the importance of recognizing subtle signs of neonatal encephalopathy that may be due to perinatal stroke, of which carotid artery dissection is an uncommon etiology. Assisted delivery techniques such as the use of forceps may be risk factors.
摘要：
颈动脉夹层是新生儿围产期中风的罕见原因。它的罕见可能是由于诊断不足或缺乏意识。我们报告了一个完整的案例，妊娠39周时分娩的大胎龄（LGA）男婴。相关的产前和围产期病史包括妊娠期糖尿病，先兆子痫,以及由于肩难产而使用镊子辅助分娩。婴儿在同居时出现呼吸暂停和紫癜，促使其进入新生儿重症监护病房（NICU）。最初的超声检查显示有梗塞，随后通过脑磁共振成像（MRI）证实为大面积左侧梗塞。Further,计算机断层扫描（CT）血管造影证实右侧颈总动脉和颈内动脉夹层。该儿童接受抗癫痫和抗血栓药物治疗。他现在正在接受定期的神经发育监测和康复。根据我们的消息来源，该病例是第一个报告由于颈动脉夹层引起的对侧重大围产期中风的病例。它强调了识别可能是由于围产期中风引起的新生儿脑病的细微体征的重要性。其中颈动脉夹层是一种罕见的病因。诸如使用镊子的辅助递送技术可能是危险因素。
