Perinatal Arterial Ischemic Stroke in Fetal Vascular Malperfusion: A Case Series and Literature Review

A F Geraldo, A Parodi, M Bertamino, F Buffelli, S Uccella, D Tortora, P Moretti, L Ramenghi, E Fulcheri, A Rossi, M Severino

Research output: Contribution to journalReview articlepeer-review


Fetal vascular malperfusion includes a continuum of placental histologic abnormalities increasingly associated with perinatal brain injury, namely arterial ischemic stroke. Here, we describe the clinical-neuroimaging features of 5 neonates with arterial ischemic stroke and histologically proved fetal vascular malperfusion. All infarcts involved the anterior territories and were multiple in 2 patients. In 2 neonates, there were additional signs of marked dural sinus congestion, thrombosis, or both. A mixed pattern of chronic hypoxic-ischemic encephalopathy and acute infarcts was noted in 1 patient at birth. Systemic cardiac or thrombotic complications were present in 2 patients. These peculiar clinical-radiologic patterns may suggest fetal vascular malperfusion and should raise the suspicion of this rare, underdiagnosed condition carrying important implications in patient management, medicolegal actions, and future pregnancy counseling.

Original languageEnglish
Pages (from-to)2377-2383
Number of pages7
JournalAJNR. American journal of neuroradiology
Issue number12
Publication statusPublished - Dec 2020


  • Female
  • Fetal Diseases/etiology
  • Fetus/blood supply
  • Humans
  • Infant, Newborn
  • Infant, Newborn, Diseases/pathology
  • Ischemic Stroke/congenital
  • Male
  • Neuroimaging/methods
  • Placenta Diseases/pathology
  • Pregnancy


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