Neonatal Updates #29

van der AA NE, Dudink J, Benders MJNL, Govaert P, van Straaten HLM, Porro GL, Groenendaal F, de Vries LS: Neonatal posterior cerebral artery stroke: Clinical presentation, mri findings, and outcome. Developmental Medicine & Child Neurology 2013, 55(3):283-290. As you would expect from this group, an excellent report of a fairly large cohort (n=18) of patients with PCA stroke. I say fairly large as this is relatively uncommon once you get down to subgroups of neonatal stroke in specific locations, but this confirms what other studies have shown: a neonatal stroke is usually followed by a relatively good outcome, unless there is more generalized brain injury (such as in asphyxia). Just shows how much plasticity there is in the brain, if there is uninjured brain to take over function.

Wadhawan R, Oh W, Vohr BR, Saha S, Das A, Bell EF, Laptook A, Shankaran S, Stoll BJ, Walsh MC et al: Spontaneous intestinal perforation in extremely low birth weight infants: Association with indometacin therapy and effects on neurodevelopmental outcomes at 18–22 months corrected age. Archives of Disease in Childhood – Fetal and Neonatal Edition 2013, 98(2):F127-F132. This database analysis from the NICHD network indicates that prophylactic indomethacin does not increases GI perforation, but that therapeutic indomethacin, in the context of a PDA, is associated with more perforations. We already know from the prospective RCTs that there isn’t any substantial risk of perforation from prophylactic indomethacin. Why giving it a little later increases the risks isn’t at all clear.

About Keith Barrington

I am a neonatologist and clinical researcher at Sainte Justine University Health Center in Montréal
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