Arterial Infarction in Preterm Infants

Arterial infarction (also called arterial ischemic stroke) is not uncommon in preterm infants and may occur antenatally, around the time of birth, and during the neonatal period, particularly in relation to episodes of sickness and interventions. Very often the onset of the stroke is not accompanied by specific symptoms, so awareness that stroke may occur in the preterm population is important and regular cranial ultrasound scanning is needed for early detection. The lesions tend to affect the central gray matter (known as perforator strokes) but are not limited to this region. As with term-born infants, the site of the lesion and whether the cortico-spinal tract is involved are very important for prognosis, and this is best defined from an MRI scan. Early detection is important for planning therapies and long-term follow-up.