Case of the Week
A five-day-old boy born full term, via normal spontaneous vaginal delivery, without complications is brought in by his parents for “shaking” earlier today.  His parents are very upset and cannot describe the duration or character of the episode.  The boy was well and was eating, sleeping, and eliminating normally before and after the episode today.  The parents are struggling to recall any possible change in tone, color, or breathing.

On examination, the child is well appearing with normal vital signs and a normal
physical examination. His parents confirm that he appears normal to them now.

During an observation period, you are called in to the room to find a crying baby with
clonic movements of the left upper extremity, lasting seconds to a minute.  The child has no evidence of apnea and his repeat vital signs after this second episode are

A CT of his head shows evidence of an early ischemic stroke.

Regarding this boy’s presenting condition, which of the following is TRUE:

    A. Most cases of stroke in full-term neonates are hemorrhagic
    B. Seizure is a common presentation of neonatal stroke
    C. Mortality from ischemic stroke in children < 1 year of age is similar to that of 
    D. Most ischemic strokes in neonates occur in cases of prematurity

In the meantime, a few quotes – 

The human body is like a bakery with a thousand windows.  We are looking into only one window of the bakery when we are investigating one particular aspect of a disease.

– Béla Schick (1877-1967), Austrian pediatrician


The proper study of geriatrics begins with pediatrics.

– David Seegal (1892-1972), US medical educator


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