Prenatal ischemic stroke as a cause of neonatal seizure diagnosed by magnetic resonance diffusion-weighted imaging

Perinatal ischemic stroke is a serious complication of pregnancy that may be attributed to certain specific risk factors associated with either some maternal or some infantile characteristics. While the occurrence of perinatal stroke may develop during the prepartum, intrapartum, or postpartum period, it is difficult to determine the exact time of occurrence because of obscure clinical manifestations in newborn babies. Here, we present the case of a neonate suffering from focal clonic seizure 24 hours after birth. The neonate was diagnosed as having perinatal ischemic stroke, which may have been caused by prenatal ischemic insult, as judged from the characteristic features in magnetic resonance (MR) diffusion-weighted imaging (DWI) performed a week after his birth. Finally, we strongly suggest that neonatal focal seizures be immediately investigated by MRI, especially with MR DWI. This image modality provides not only early diagnosis of perinatal ischemic stroke, but also assists to clarify the specific time (prepartum, intrapartum, or postpartum period) of the stroke's occurrence.