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Top of the basilar artery embolic stroke and neonatal myoclonus
Article first published online: 22 JAN 2009
© The Authors. Journal compilation © Mac Keith Press 2008
Developmental Medicine & Child Neurology
Volume 51, Issue 4, pages 324–327, April 2009
How to Cite
GOVAERT, P., DUDINK, J., VISSER, G., BREUKHOVEN, P., VANHATALO, S. and LEQUIN, M. (2009), Top of the basilar artery embolic stroke and neonatal myoclonus. Developmental Medicine & Child Neurology, 51: 324–327. doi: 10.1111/j.1469-8749.2008.03183.x
Acknowledgments We are grateful to Liesbeth Smit, neuropaediatrician at Sophia Children’s Hospital, Erasmus MC – University Medical Center Rotterdam, who was responsible for the acute treatment and follow-up of the patient described.
- Issue published online: 18 MAR 2009
- Article first published online: 22 JAN 2009
- PUBLICATION DATA Accepted for publication 12th August 2008. Published online 22nd January 2009.
Vol. 51, Issue 9, 761, Article first published online: 23 JUL 2009
Cerebellar stroke has been virtually unreported in the living newborn infant. A term newborn male weighing 3380g at birth suffered myoclonic seizures within 24 hours of birth by spontaneous vaginal delivery. Apgar scores were 3 and 4 at 1 and 5 minutes. Myoclonus persisted for 9 days, responding poorly to step-up anticonvulsant treatment including lidocaine, midazolam, and clonazepam. Imaging documented arterial ischaemic stroke within the left posterior cerebral and both superior cerebellar arteries, compatible with top of the basilar artery stroke. There was no electrographic correlate for the seizures. Disturbed oscillation within the dentato-rubro-olivary circuitry was the likely mechanism. The probable cause was embolism from an in-utero-onset inferior caval vein thrombosis. At 22 months the child was sitting unsupported. Scores on the Bayley Scales of Infant Development II were equivalent to those of a 12-month-year-old. He showed ataxic motor behaviour. Embolism can cause neonatal top of the basilar artery stroke, which may present with myoclonus due to cerebellar injury.