Cerebrovascular disorders in the prenatal period

Fetal stroke can occur between the 14th week of pregnancy and the beginning of labor. The incidence is approximately 17-35 of 100,000 live births. Risk factors are correlated to the mother, the pregnancy, or the factors associated with the fetus itself. Computerized tomography and magnetic resonance imaging are the most commonly used imaging techniques. The authors studied 3 cases with neurological symptoms by magnetic resonance imaging and magnetic resonance-angiography. In these cases, the authors found massive involvement of the left hemisphere that was presumptively correlated with the persistence of the oval foramen. Magnetic resonance-angiography showed a flow reduction in the left cerebral vessels, and in 1 case, there was also persistence of the fetal primitive trigeminal artery. The discrepancy between the extent of the cerebral lesions and the neurological symptoms is associated with cerebral plasticity, which is greater in damage occurring early in fetal life.