[Revelation of the circumstances of the accident vascular arterial ischemic brain in at term or near-term and referral]. / Circonstances de révélation de l'accident vasculaire cérébral ischémique artériel chez le nouveau-né à terme ou proche du terme et orientation des patients.

ABSTRACT

The neonatal arterial ischemic stroke is an emergency. Recurrent focal seizures, generally occurring in the first 24-72 hours after birth, are the commonest first clinical signs. When neonatal arterial ischemic stroke is suspected, optimal initial management involves careful supportive care including treatment of clinical and frequent or prolonged subclinical seizures, correction of the possible metabolic disorders and their prevention. Contrary to hypoxic ischemic encephalopathy, therapeutic hypothermia is not indicated. This newborn requires emergent transfer to a neonatal intensive care unit for the confirmation of the diagnosis by means of a specialized neonatal transport team.