Perinatal Arterial Ischemic Stroke: An Unusual Causal Mechanism

Perinatal arterial ischemic stroke (AIS) is estimated to occur in 1/1600 to 1/5000 births [1]. Even if rare, it is an important cause of mortality and morbidity in neonates. A meta-analysis showed that 57% of infants who suffer perinatal AIS develop motor and/or cognitive deficits, and 3% die [2]. Risk factors proposed for perinatal AIS include maternal prothrombotic conditions and pre-eclampsia, chorioamnionitis, fetal distress, and placental disorders, such as thrombosis and placental chorioangiomas [1-4]. Although clinical and imaging findings of AIS are now well delineated, its causative mechanisms remain unclear. In the absence of documented pathogenic mechanisms, preventive strategies cannot be implemented. We report a case of perinatal AIS which we correlated to the presence of undiagnosed vasa praevia.