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(Stroke. 2008;39:e35.)
© 2008 American Heart Association, Inc.

Letters to the Editor

Perinatal Stroke With No Obvious Cause

Péter Temesvári, MD, PhD, DSc

Department of Pediatrics, University Teaching Hospital, Orosháza, Hungary

To the Editor:

In the population-based study from Estonia on the epidemiological characteristics of perinatal stroke,¹ the authors analyzed the clinical data of 38 affected patients. Previously identified risk factors for perinatal stroke occurred only in 32% of cases. Neonatal pneumothorax not included into the list of risk factors might result in this serious cerebral event.

We were the first who demonstrated the origin of cerebral arterial air embolization in neonates with pneumothorax.^2,3 In the cited article¹ 58% of the affected newborns had respiratory problems, and 5 were intubated and needed artificial ventilation. Pneumothorax is the most common complication occurring in 30% to 50% of those infants who require mechanical ventilation.⁴

Moreover, neonatal pneumothorax remains frequently silent, clinically. Because only macroscopic bubbles are identifiable by cranial radiology⁵ performed in the affected neonates, we may suppose that some of them might have cerebral arterial air embolization leading to stroke, originating from their respiratory complications.

Acknowledgments

Disclosures

None.

References

1. Laugessaar R, Kolk A, Tomberg T, Metsvaht T, Lintrop M, Varendi H, Tavlik T. Acutely and retrospectively diagnosed perinatal stroke: a population–based study. Stroke. 2007; 38: 2234–2240.[Abstract/Free Full Text]

2. Temesvári P, Kovács J, Rácz K. Cerebral arterial air embolism in experimental neonatal pneumothorax. Arch Dis Child. 1989, 64: 178.[Free Full Text]

3. Temesvári P, Kovács J, Ábrahám CS. Pneumothorax and neonatal stroke. Neuropediatrics. 1996, 27: 167–168.[Medline] [Order article via Infotrieve]

4. Textbook of Neonatology. Roberton NRC, ed. London: Churchill Livingstone; 1992: 450.

5. Menéndez-González M, Oliva-Nacarino P, Alvarez-Cofino A. Cerebral gas embolism caused by pleural fibrinolytic treatment. Stroke. 2007, 38: 2602–2604.[Abstract/Free Full Text]

Related Article:

Response to Letter by Temesvári

Tuuli Metsvaht, Rael Laugesaar, Anneli Kolk, and Tiina Talvik
Stroke 2008 39: e36-e37. [Extract] [Full Text] [PDF]

This Article Extract Full Text (PDF) All Versions of this Article: 39/2/e35    most recent STROKEAHA.107.506907v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Temesvári, P. Search for Related Content PubMed PubMed Citation Articles by Temesvári, P. Pubmed/NCBI databases Medline Plus Health Information Infant and Toddler Health Pleural Disorders Stroke Related Collections Related Article