Mixed Neonatal Stroke Associated with Hypoxic-Ischemic Encephalopathy, Multiple Hemorrhages, and Dural Venous Thrombosis: A Case Report

Abstract

Introduction: Neonatal stroke is a significant cause of acquired brain injury in the perinatal period and may involve overlapping ischemic, hemorrhagic and thrombotic mechanisms, particularly in the setting of perinatal asphyxia.

Case report: We present the case of a term newborn born to a mother with type 2 diabetes, who developed severe neonatal depression and metabolic acidosis consistent with perinatal asphyxia. Neuroimaging revealed moderate to severe hypoxic-ischemic encephalopathy associated with multiple hemorrhages and findings suggestive of dural venous thrombosis. This case illustrates the pathophysiological interaction between hypoxia, endothelial dysfunction and hemostatic alterations in mixed neonatal stroke.

Conclusion: Early clinical suspicion, timely use of magnetic resonance imaging and a multidisciplinary approach are essential to optimize neurological outcomes. This case provides clinical evidence on the interaction between systemic hypoxia and cerebral venous thrombosis in neonates, a phenomenon poorly described in the literature.