What is Neonatal Cerebral Arterial Infarction?

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Neonatal cerebral arterial infarction (NCI) is a cerebral damage caused by a focal interruption of cerebral blood flow secondary to an obstruction (embolism) in the artery before 28 days of postnatal life. It affects about 3 in every 10,000 live births and is diagnosed through neuroimaging tests.

In western countries, it is estimated to affect 3 in every 1,000 live births. Newborns with altered prothrombotic factors and congenital heart disease or dehydration are associated with a higher risk of recurrence. It occurs more frequently in males at a ratio of 1-3.

The reasons behind its occurrence are not known as the diagnosis is sometimes delayed beyond a year of life. In the neonatal period, patients have non-specific symptoms or are asymptomatic so it goes unnoticed; while others are diagnosed in childhood following the appearance of hemiplegia, presumably due to perinatal infarcts.

NCI is the first known cause of hemiplegic cerebral palsy, although it is estimated that approximately one third of cases are not diagnosed in the neonatal period.

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