Stroke in newbornsSStroke in newbornsStroke in newbornsEnglishNeurologyNewborn (0-28 days)BrainArteries;VeinsConditions and diseasesCaregivers Adult (19+)NA2010-03-12T05:00:00ZAndrew James, MBChB, FRACP, FRCPC;Gabrielle deVeber, MD, FRCPC10.000000000000056.00000000000001800.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about strokes occuring in newborns. Stroke occurs as frequently in newborns as in the elderly, yet it often goes unrecognized and untreated.</p><p>Most people think of stroke as a disease of old age. But newborns have as high a risk of stroke as the elderly. Stroke in the first 28 days of life is much more common than parents realize. Yet stroke in this fragile age group remains largely unrecognized and thus untreated.</p><h2>What is stroke and how common is it?</h2><p>A stroke is a sudden stoppage or decrease in the flow of blood in the brain, severe enough that it causes damage to the brain. There are two types of stroke: ischemic and hemorrhagic.<br></p><p>Ischemic stroke is when the blood flow to the brain is diminished, usually because of a clot, called a thrombus, in one of the blood vessels in the brain. There are two types of ischemic stroke that occur in children, especially newborns: <a href="/Article?contentid=855&language=English"> sinovenous thrombosis</a>, where there is a clot in one of the veins in the brain, and <a href="/Article?contentid=854&language=English">arterial ischemic stroke</a>, where the clot is in an artery in the brain.<br></p><p>Hemorrhagic stroke is when a blood vessel in or near the brain ruptures, causing bleeding in the brain.</p> <figure class="asset-c-80"><span class="asset-image-title">Types of stroke</span><img src="https://assets.aboutkidshealth.ca/akhassets/Stroke_MED_ILL_EN.png" alt="" /> </figure> <p>The incidence of stroke in the newborn period is very high compared to infancy and childhood. Sinovenous thrombosis occurs in one out of 6,000 newborns, arterial ischemic stroke in one of 4,000 newborns, and hemorrhagic stroke in one of 4,000 newborns. After the newborn period, the risk of stroke drops significantly, and remains low until old age.</p><br><h2>Key points</h2><ul><li>A stroke is a sudden stoppage or decrease in the flow of blood in the brain, which causes damage in the brain.</li><li>There are two types of stroke: ischemic and hemorrhagic. There are two subtypes of ischemic stroke that occur in children, especially newborns.</li><li>Risk factors for stroke in newborns include birth defects involving a hole in the heart, a family history of clotting problems, serious infection, dehydration and childbirth.</li><li>Stroke may be diagnosed during pregnancy, but an infant cannot be treated for the condition until after they are born.</li><li>To prevent stroke, expectant mothers should maintain a healthy diet, not smoke cigarettes and avoid becoming dehydrated.<br></li></ul><h2>What are the symptoms of stroke in newborns?</h2> <p>Stroke in newborns usually shows no clinical symptoms, and the problem often goes unrecognized and thus untreated until the baby is much older. The usual symptoms seen in older children and adults, such as speech problems, numbness on one side, or imbalance, are difficult or impossible to detect in a newborn.</p> <p>Of the newborns who do show symptoms, the vast majority present with a seizure. Seizure is the most recognizable sign of stroke in this age group. The symptoms of seizure are sometimes difficult to spot in newborns, and they include the following: </p> <ul> <li>repetitive facial movements, including sucking, chewing or eye movements </li> <li>unusual bicycling or pedaling movements </li> <li>staring </li> <li>apnea, or pauses in breathing associated with slowing of the heart </li> <li>rhythmic jerking movements involving the muscles of the face, tongue, arms, legs or other regions </li> <li>stiffening or tightening of muscle groups </li> <li>quick, single jerks involving one arm or leg or the whole body </li> </ul> <p>One major sign of stroke in adults is weakness on one side of the body. However, the newborn brain is immature and this symptom may not appear in a newborn victim of stroke. Generally, about 15% of newborn stroke victims show less movement on one side of their body. One-sided weakness becomes easier to recognize as the baby gets older. </p> <p>"Handedness" is a symptom of stroke that may arise some time after the newborn period, from around six weeks to six months of life. These babies may favour their left or right hand and reach out more with that hand. Some parents mistake this as meaning that the baby is advanced for their age, when really it is a sign of stroke. In healthy children, handedness does not normally appear until about 12 months. </p><h2>Why do strokes occur in newborns?</h2> <p>In pregnancy, proteins come across the placenta from mother to fetus, which help to decrease the risk of bleeding. However, this puts the fetus at higher risk for clotting and stroke. Also, sometimes clots can form in the placenta and travel to the fetus' blood circulation. These clots may eventually make their way to the baby's brain and cause a stroke. </p> <p>Labour and delivery is another common time when stroke can occur in newborns. Childbirth can cause tremendous strain on the baby's head. Stress on the arteries and veins in the baby's head may lead to clot formation and stroke. </p> <p>In addition, newborns come into the world with thicker blood than the rest of us, twice as many red blood cells as an adult, and this in itself can lead to clotting. In the first few days after birth, dehydration can be a problem, which can also cause the blood to clot. </p> <h2>What are the risk factors for stroke in newborns?</h2> <p>There are a number of factors that can put a newborn at higher risk for stroke. If the newborn has a birth defect that involves a hole in the heart, it is easier for clots to pass from other parts of the body, through the heart, and up to the brain. If there is a family history of clotting problems, the risk of stroke is higher in the newborn. Serious infections such as sepsis and meningitis can also lead to clotting. Other risk factors are those previously described, such as dehydration and childbirth. </p><h2>How is newborn stroke diagnosed?</h2> <p>Sometimes stroke can be diagnosed while the baby is still in the womb. Generally this occurs if a birth defect is suspected and the mother is given a test called fetal magnetic resonance imaging (MRI). The fetal MRI is very effective at detecting stroke in the fetus. In some fetuses, if the stroke is particularly severe, it can be detected on a normal ultrasound during pregnancy. Once the baby is born, further imaging of the brain can be done to confirm the diagnosis. </p> <p>In addition, all newborns who have a seizure should be given an ultrasound and CT of the head. They may also be given an MRI. The MRI is more sensitive but any stroke of significance would be seen on a CT. In an ideal world, an MRI would be done first, followed by other tests called a magnetic resonance arteriogram (MRA) and a magnetic resonance venogram (MRV), to look more closely at the blood vessels in the brain. </p><h2>How is newborn stroke treated?</h2> <p>Although stroke can be diagnosed during pregnancy, the fetus cannot actually be treated for the condition until after they are born. Once the baby is born, it is not possible to reverse the damage that has been caused by the stroke. However, sometimes a medication called an anticoagulant can be given to prevent the clot from getting worse. An anticoagulant decreases the clotting ability of the blood. If the baby has had an ischemic stroke, and there is no evidence of bleeding in the brain, an anticoagulant can be used to stop the clot from getting worse. </p> <p>Research has shown that the use of an anticoagulant is safe in the treatment of sinovenous thrombosis with no bleeding in the brain. Almost one-quarter of newborns with this type of stroke who do not receive an anticoagulant have a worsening of their blood clot. </p> <p>On the other hand, newborns who have arterial ischemic stroke generally do not need an anticoagulant unless there is an additional blood clot in the heart that could move up to the brain. </p> <p>If the baby has had a hemorrhagic stroke, which means that there is bleeding in the brain, an anticoagulant should not be used because it will make the bleeding worse. </p>
Les accidents vasculaires cérébraux chez les nouveau-nésLLes accidents vasculaires cérébraux chez les nouveau-nésStroke in newbornsFrenchNeurologyNewborn (0-28 days)BrainArteries;VeinsConditions and diseasesAdult (19+) CaregiversNA2010-03-12T05:00:00ZAndrew James, MBChB, FRACP, FRCPC;Gabrielle deVeber, MD, FRCPCHealth (A-Z) - ConditionsHealth A-Z<p>Lisez à propos des accidents vasculaires cérébraux chez les nouveau-nés. Leur fréquence est semblable entre les nouveau-nés et les personnes âgées. Malgré tout, ils sont souvent non diagnostiqués et non traités. </p><p>La plupart des gens pensent que l’accident vasculaire cérébral est une maladie liée à la vieillesse. Par contre, le risque d’accident vasculaire cérébral chez les nouveau-nés est semblable à celui chez les personnes âgées. L’accident vasculaire cérébral dans les 28 premiers jours de la vie est beaucoup plus commun que les parents ne le pensent. Cependant, l’accident vasculaire cérébral dans ce groupe d’âge vulnérable n’est souvent pas diagnostiqué et n’est donc pas traité. </p><h2>Qu’est-ce que l’accident vasculaire cérébral et quelle est sa fréquence ?</h2><p>Un accident vasculaire cérébral est un arrêt subit ou une diminution du flot sanguin au cerveau, assez sévère pour endommager le cerveau. Il existe deux types d’accidents vasculaires cérébraux : ischémique et hémorragique.</p><p>L’accident vasculaire cérébral ischémique survient lorsque le flot sanguin au cerveau est diminué, habituellement causé par un caillot, aussi appelé thrombus, qui s’est logé dans un des vaisseaux sanguins cérébraux. Il existe deux types d’accidents vasculaires cérébraux ischémiques chez les enfants, plus particulièrement chez les nouveau-nés : la <a href="/Article?contentid=855&language=French">thrombose des sinus veineux</a> cérébraux lorsque le caillot s’est logé dans une veine cérébrale, et l’accident vasculaire cérébral <a href="/Article?contentid=854&language=French">artériel ischémique</a> lorsque le caillot s’est logé dans une artère cérébrale.</p><p>L’accident vasculaire cérébral hémorragique survient lorsqu’un vaisseau sanguin du cerveau ou près du cerveau se rompt, causant une hémorragie cérébrale.</p> <figure class="asset-c-80"> <span class="asset-image-title">Types d’accidents vasculaires cérébraux</span><img src="https://assets.aboutkidshealth.ca/akhassets/Stroke_MED_ILL_FR.png" alt="" /></figure> <p>L’incidence de l’accident vasculaire cérébral chez le nouveau-né est très élevée en comparaison à celle chez le nourrisson et pendant l’enfance. La thrombose des sinus veineux cérébraux affecte un nouveau-né sur 6000, un nouveau-né sur 4000 pour l’accident vasculaire cérébral ischémique et un nouveau-né sur 4000 pour l’accident vasculaire cérébral hémorragique. Le risque d’avoir un accident vasculaire cérébral diminue de façon significative après la période néonatale et reste bas jusqu’à la vieillesse.</p><h2>À retenir</h2><ul><li>Un accident vasculaire cérébral (AVC) est un arrêt subit ou une diminution du flux sanguin au cerveau qui endommage ce dernier.</li><li>Il existe deux types d’AVC : ischémique et hémorragique. On classe en deux sous-types les accidents ischémiques dont souffrent les enfants, notamment les nouveau-nés.</li><li>Les facteurs de risque chez les nouveau-nés comprennent des anomalies congénitales causant une communication intracardiaque, des antécédents familiaux de problèmes de coagulation, une infection grave, la déshydratation et l’accouchement.</li><li>Même si l’on peut diagnostiquer un AVC chez le fœtus pendant la grossesse, on ne peut toutefois traiter ce trouble qu’après la naissance.</li><li>Pour prévenir les AVC, les femmes enceintes devraient suivre un régime sain et éviter de fumer ou de devenir déshydratées.</li></ul><h2>Quels sont les symptômes d’un accident vasculaire cérébral chez les nouveau-nés ?</h2><p>Les nouveau-nés ne présentent pas habituellement de symptômes cliniques lors d’un accident vasculaire cérébral. Le problème passe souvent inaperçu et n’est donc souvent pas traité jusqu’à ce que l’enfant soit plus âgé. Les symptômes communs observés chez des enfants plus âgés ou des adultes tels que les problèmes d’élocution, un engourdissement unilatéral ou une perte d’équilibre sont difficiles ou impossibles à détecter chez le nouveau-né.</p><p>Parmi tous les nouveau-nés symptomatiques, la grande majorité aura des convulsions. C’est le symptôme d’accident vasculaire cérébral le plus caractéristique chez ce groupe d’âge. Les symptômes de convulsion sont parfois difficiles à identifier, et comprennent les signes suivants :</p><ul><li>des mouvements faciaux répétitifs de succion, de mastication ou des mouvements oculaires;</li><li>des mouvements anormaux de bicyclette ou de pédalage;</li><li>regarder fixement;</li><li>l’apnée, ou des pauses dans la respiration associées à un ralentissement des battements du cœur;</li><li>des mouvements rythmés et saccadés des muscles faciaux, de la langue, des bras, des jambes et d’autres parties du corps;</li><li>un raidissement ou resserrement de groupes musculaires;</li><li>des secousses rapides et uniques d’un seul bras ou d’une seule jambe, ou de tout le corps.</li></ul><p>Un des symptômes principaux d’un accident vasculaire cérébral chez l’adulte est une faiblesse d’un seul côté du corps. Par contre, puisque le cerveau du nouveau-né est immature, ce symptôme ne peut pas être observé chez les nouveau-nés victimes d’un accident vasculaire cérébral. En général, environ seulement 15 % de ces petites victimes démontrent moins de mouvements d’un seul côté de leur corps. Cette faiblesse unilatérale est plus facile à observer chez les nourrissons plus âgés. La « préférence manuelle » est un symptôme qui peut apparaître quelque temps après la période néonatale, lorsque l’enfant est âgé entre six semaines et six mois. Ces bébés préféreront utiliser soit leur main gauche ou leur main droite et attraperont les objets davantage avec cette main. Certains parents voient cette préférence comme un signe d’habiletés précoces, alors que c’est le symptôme d’un accident vasculaire cérébral. La préférence manuelle apparait seulement après l’âge de 12 mois chez les enfants en santé.</p><h2>Pourquoi y a-t-il des accidents vasculaires cérébraux chez les nouveau-nés ?</h2><p>Au cours de la grossesse, des protéines passent à travers le placenta de la mère vers le bébé, ce qui aide à réduire le risque d’hémorragie. Par contre, ceci augmente le risque de formation de caillots et d’accident vasculaire cérébral chez le fœtus. De plus, des caillots peuvent parfois se former dans le placenta et se déplacer dans la circulation sanguine du fœtus. Ces caillots peuvent éventuellement atteindre le cerveau du bébé et causer un accident vasculaire cérébral.</p><p>La période du travail et de l’accouchement est un autre moment propice à l’accident vasculaire cérébral. L’accouchement peut causer beaucoup de pression sur la tête du bébé ainsi que sur les artères et les veines cérébrales, ce qui peut causer la formation de caillots et un accident vasculaire cérébral. Par ailleurs, le sang des nouveau-nés est plus épais que celui des enfants plus vieux ou des adultes (il y a deux fois plus de globules rouges dans le sang d’un nouveau-né que dans le sang d’un adulte), ce qui augmente les chances de formation de caillots. Dans les premiers jours après la naissance, la déshydratation peut être une complication qui peut entraîner la formation de caillots sanguins.</p><h2>Quels sont les facteurs de risque d’un accident vasculaire cérébral chez les nouveau-nés ?</h2><p>Plusieurs facteurs peuvent rendre un nouveau-né vulnérable à un accident vasculaire cérébral. Si le nouveau-né a une anomalie congénitale causant une communication intracardiaque, il est plus facile pour un caillot de passer d’une région du corps à l’autre, à travers le cœur et vers le cerveau. S’il existe des antécédents familiaux de problèmes de coagulation, le risque d’accident vasculaire cérébral est plus élevé chez le nouveau-né. Certaines infections comme une septicémie ou une méningite peuvent mener à la formation de caillots. D’autres facteurs de risques comme la déshydratation et l’accouchement ont été décrits précédemment.</p><h2>Comment diagnostiquer l’accident vasculaire cérébral chez le nouveau-né ?</h2><p>L’accident vasculaire cérébral peut parfois être diagnostiqué alors que le bébé est encore dans l’utérus. Ceci survient généralement lorsque l’on soupçonne l’existence d’une malformation congénitale et que l’on fait passer un test d’imagerie par résonance magnétique (IRM) fœtale à la mère. Il est très facile de détecter les accidents vasculaires cérébraux chez le fœtus au cours de ce test. Chez certains fœtus, un accident vasculaire cérébral très grave peut être détecté à l’échographie au cours de la grossesse. Des tests d’imagerie additionnels peuvent être effectués après la naissance pour confirmer le diagnostic.</p><p>De plus, tous les nouveau-nés ayant des convulsions devraient subir une échographie et une tomodensitométrie de la tête. Ils pourraient également avoir à subir un test d’imagerie par résonance magnétique. Même si l’imagerie par résonance magnétique est plus sensible, tous les accidents vasculaires cérébraux peuvent être détectés à la tomodensitométrie. Dans un monde idéal, un test d’imagerie par résonance magnétique serait passé en premier, suivi d’un artériogramme par résonance magnétique (ARM) et d’un veinogramme par résonance magnétique (VRM) afin d’examiner plus en détail les vaisseaux sanguins du cerveau.</p><h2>Comment traiter l’accident vasculaire cérébral chez le nouveau-né ?</h2><p>Même si l’on peut poser le diagnostic d’accident vasculaire cérébral au cours de la grossesse, le fœtus ne peut pas recevoir de traitement avant l’accouchement. Les dommages causés par l’accident vasculaire cérébral sont irréversibles, même après la naissance du bébé. Par contre, des anticoagulants peuvent parfois être administrés pour éviter le grossissement du caillot. Un anticoagulant diminue la capacité du sang à coaguler. Un anticoagulant peut être administré pour éviter le grossissement du caillot si le nourrisson a subi un accident vasculaire cérébral ischémique sans hémorragie cérébrale.</p><p>Les études ont démontré que l’utilisation d’un anticoagulant est sans danger pour de traiter une thrombose des sinus veineux cérébraux sans hémorragie cérébrale. Près d’un quart des nouveau-nés atteints de ce type d’accident vasculaire cérébral qui ne reçoivent pas d’anticoagulant démontrent un élargissement de leur caillot sanguin.</p><p>En contrepartie, les nouveau-nés atteints d’un accident vasculaire cérébral artériel ischémique n’ont habituellement pas besoin d’un anticoagulant à moins qu’un caillot additionnel présent dans le cœur menace de monter au cerveau. Un anticoagulant ne devrait pas être administré si le nourrisson a subi un accident vasculaire cérébral hémorragique, c’est-à-dire qu’il y a un saignement dans le cerveau, car cela pourrait empirer le saignement.</p>

 

 

Stroke in newborns860.000000000000Stroke in newbornsStroke in newbornsSEnglishNeurologyNewborn (0-28 days)BrainArteries;VeinsConditions and diseasesCaregivers Adult (19+)NA2010-03-12T05:00:00ZAndrew James, MBChB, FRACP, FRCPC;Gabrielle deVeber, MD, FRCPC10.000000000000056.00000000000001800.00000000000Health (A-Z) - ConditionsHealth A-Z<p>Learn about strokes occuring in newborns. Stroke occurs as frequently in newborns as in the elderly, yet it often goes unrecognized and untreated.</p><p>Most people think of stroke as a disease of old age. But newborns have as high a risk of stroke as the elderly. Stroke in the first 28 days of life is much more common than parents realize. Yet stroke in this fragile age group remains largely unrecognized and thus untreated.</p><h2>What is stroke and how common is it?</h2><p>A stroke is a sudden stoppage or decrease in the flow of blood in the brain, severe enough that it causes damage to the brain. There are two types of stroke: ischemic and hemorrhagic.<br></p><p>Ischemic stroke is when the blood flow to the brain is diminished, usually because of a clot, called a thrombus, in one of the blood vessels in the brain. There are two types of ischemic stroke that occur in children, especially newborns: <a href="/Article?contentid=855&language=English"> sinovenous thrombosis</a>, where there is a clot in one of the veins in the brain, and <a href="/Article?contentid=854&language=English">arterial ischemic stroke</a>, where the clot is in an artery in the brain.<br></p><p>Hemorrhagic stroke is when a blood vessel in or near the brain ruptures, causing bleeding in the brain.</p> <figure class="asset-c-80"><span class="asset-image-title">Types of stroke</span><img src="https://assets.aboutkidshealth.ca/akhassets/Stroke_MED_ILL_EN.png" alt="" /> </figure> <p>The incidence of stroke in the newborn period is very high compared to infancy and childhood. Sinovenous thrombosis occurs in one out of 6,000 newborns, arterial ischemic stroke in one of 4,000 newborns, and hemorrhagic stroke in one of 4,000 newborns. After the newborn period, the risk of stroke drops significantly, and remains low until old age.</p><br><h2>Key points</h2><ul><li>A stroke is a sudden stoppage or decrease in the flow of blood in the brain, which causes damage in the brain.</li><li>There are two types of stroke: ischemic and hemorrhagic. There are two subtypes of ischemic stroke that occur in children, especially newborns.</li><li>Risk factors for stroke in newborns include birth defects involving a hole in the heart, a family history of clotting problems, serious infection, dehydration and childbirth.</li><li>Stroke may be diagnosed during pregnancy, but an infant cannot be treated for the condition until after they are born.</li><li>To prevent stroke, expectant mothers should maintain a healthy diet, not smoke cigarettes and avoid becoming dehydrated.<br></li></ul><h2>What are the symptoms of stroke in newborns?</h2> <p>Stroke in newborns usually shows no clinical symptoms, and the problem often goes unrecognized and thus untreated until the baby is much older. The usual symptoms seen in older children and adults, such as speech problems, numbness on one side, or imbalance, are difficult or impossible to detect in a newborn.</p> <p>Of the newborns who do show symptoms, the vast majority present with a seizure. Seizure is the most recognizable sign of stroke in this age group. The symptoms of seizure are sometimes difficult to spot in newborns, and they include the following: </p> <ul> <li>repetitive facial movements, including sucking, chewing or eye movements </li> <li>unusual bicycling or pedaling movements </li> <li>staring </li> <li>apnea, or pauses in breathing associated with slowing of the heart </li> <li>rhythmic jerking movements involving the muscles of the face, tongue, arms, legs or other regions </li> <li>stiffening or tightening of muscle groups </li> <li>quick, single jerks involving one arm or leg or the whole body </li> </ul> <p>One major sign of stroke in adults is weakness on one side of the body. However, the newborn brain is immature and this symptom may not appear in a newborn victim of stroke. Generally, about 15% of newborn stroke victims show less movement on one side of their body. One-sided weakness becomes easier to recognize as the baby gets older. </p> <p>"Handedness" is a symptom of stroke that may arise some time after the newborn period, from around six weeks to six months of life. These babies may favour their left or right hand and reach out more with that hand. Some parents mistake this as meaning that the baby is advanced for their age, when really it is a sign of stroke. In healthy children, handedness does not normally appear until about 12 months. </p><h2>Why do strokes occur in newborns?</h2> <p>In pregnancy, proteins come across the placenta from mother to fetus, which help to decrease the risk of bleeding. However, this puts the fetus at higher risk for clotting and stroke. Also, sometimes clots can form in the placenta and travel to the fetus' blood circulation. These clots may eventually make their way to the baby's brain and cause a stroke. </p> <p>Labour and delivery is another common time when stroke can occur in newborns. Childbirth can cause tremendous strain on the baby's head. Stress on the arteries and veins in the baby's head may lead to clot formation and stroke. </p> <p>In addition, newborns come into the world with thicker blood than the rest of us, twice as many red blood cells as an adult, and this in itself can lead to clotting. In the first few days after birth, dehydration can be a problem, which can also cause the blood to clot. </p> <h2>What are the risk factors for stroke in newborns?</h2> <p>There are a number of factors that can put a newborn at higher risk for stroke. If the newborn has a birth defect that involves a hole in the heart, it is easier for clots to pass from other parts of the body, through the heart, and up to the brain. If there is a family history of clotting problems, the risk of stroke is higher in the newborn. Serious infections such as sepsis and meningitis can also lead to clotting. Other risk factors are those previously described, such as dehydration and childbirth. </p><h2>How is newborn stroke diagnosed?</h2> <p>Sometimes stroke can be diagnosed while the baby is still in the womb. Generally this occurs if a birth defect is suspected and the mother is given a test called fetal magnetic resonance imaging (MRI). The fetal MRI is very effective at detecting stroke in the fetus. In some fetuses, if the stroke is particularly severe, it can be detected on a normal ultrasound during pregnancy. Once the baby is born, further imaging of the brain can be done to confirm the diagnosis. </p> <p>In addition, all newborns who have a seizure should be given an ultrasound and CT of the head. They may also be given an MRI. The MRI is more sensitive but any stroke of significance would be seen on a CT. In an ideal world, an MRI would be done first, followed by other tests called a magnetic resonance arteriogram (MRA) and a magnetic resonance venogram (MRV), to look more closely at the blood vessels in the brain. </p><h2>How is newborn stroke treated?</h2> <p>Although stroke can be diagnosed during pregnancy, the fetus cannot actually be treated for the condition until after they are born. Once the baby is born, it is not possible to reverse the damage that has been caused by the stroke. However, sometimes a medication called an anticoagulant can be given to prevent the clot from getting worse. An anticoagulant decreases the clotting ability of the blood. If the baby has had an ischemic stroke, and there is no evidence of bleeding in the brain, an anticoagulant can be used to stop the clot from getting worse. </p> <p>Research has shown that the use of an anticoagulant is safe in the treatment of sinovenous thrombosis with no bleeding in the brain. Almost one-quarter of newborns with this type of stroke who do not receive an anticoagulant have a worsening of their blood clot. </p> <p>On the other hand, newborns who have arterial ischemic stroke generally do not need an anticoagulant unless there is an additional blood clot in the heart that could move up to the brain. </p> <p>If the baby has had a hemorrhagic stroke, which means that there is bleeding in the brain, an anticoagulant should not be used because it will make the bleeding worse. </p><h2>What precautions can be taken to prevent stroke in newborns?</h2> <p>Because many newborn strokes actually occur in pregnancy, every precaution should be taken to make sure the fetus receives healthy blood flow while in the womb. Expectant mothers should eat properly, refrain from cigarette smoking and avoid becoming dehydrated. </p> <p>If an expectant mother has a history or family history of clotting disorders, she should be tested to see if she carries a genetic problem called Factor V Leiden, which can cause clotting in the baby. If doctors know that the baby may have this condition, they can take the necessary steps to manage it. </p> <p>If a baby has too many red blood cells, which can arise if there is a problem during pregnancy or childbirth, the newborn may be prone to developing clots. Stroke can sometimes be prevented in these newborns by giving them a partial exchange blood transfusion where the blood is diluted with saline. </p> <p>Once the baby is born, dehydration can sometimes cause the blood to clot. Bring your newborn in to see a doctor if you notice any of the following signs of dehydration: </p> <ul> <li>dry mouth </li> <li>less than six wet diapers per day </li> <li>tearless and sunken eyes </li> <li>a sunken fontanel, which is the 'soft spot' at the top of your newborn's head</li> <li>dry skin </li> </ul> <p>It is important for parents to be aware of stroke in the newborn period. If you think that something is wrong with your baby, bring them to the family doctor. Do not worry that you are over-reacting. It is better to be safe than sorry. If your family doctor agrees that your baby could have had a stroke, they will refer your baby to a paediatrician who will launch an investigation. </p><h2>What are the outcomes of stroke in newborns?</h2> <p>The newborn brain is "plastic," and therefore it is more able to recover after stroke than an adult brain. The nerve cells in the newborn brain are still forming connections, and this makes it easier for the baby to transfer important functions to other parts of the brain. For example, if the stroke occurred in the part of the brain that controls speech, as the baby gets older, he might be able to transfer control of this function to the other side of the brain. Because of the plasticity of the newborn brain, a newborn may have a significant stroke and still be neurodevelopmentally normal. </p> <p>With that said, there are a number of common complications that can arise from stroke in newborns. Cerebral palsy is the most common complication. Epilepsy, language problems, cognitive or behavioural problems, headache disorders and seizure disorders can all emerge as a result of newborn stroke. These conditions require special care over the long term, to ensure the best possible quality of life for the child. </p>https://assets.aboutkidshealth.ca/akhassets/Stroke_MED_ILL_EN.pngStroke in newbornsFalse

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