Clinical Practice and Cases in Emergency Medicine

Introduction: Perinatal stroke is a rare but clinically significant condition that can present in a variety of ways, which can result in diagnostic challenges in a particularly vulnerable population.  We present the case of a term neonate who presented with left arm swelling, ultimately diagnosed with perinatal stroke.

Case Report: A term male neonate presented to the emergency department with left arm swelling noted the day prior, with abnormal tone of the left arm since birth.  Physical examination revealed mild erythema and edema localized to the left upper extremity, with the arm held in flexion.  Neurological examination was otherwise unremarkable.  Further evaluation, including imaging studies, demonstrated thrombi in the left axillary and subclavian arteries, as well as an infarct involving the right middle cerebral artery (MCA) and anterior cerebral artery (ACA) with diffusion restriction, consistent with perinatal stroke.

Conclusion: Through this case report, we aim to increase awareness of perinatal stroke among healthcare professionals and highlight the importance of prompt recognition and appropriate management in optimizing outcomes for affected infants.