Evaluations, including MRI, MR angiography, and neuropsychological tests, at 1.5-8.4 years, of 8 infants after neonatal stroke involving the middle cerebral artery are reported from the University of Heidelberg, Mannheim, Germany. Seven had mental and motor retardation and hemiparesis and 4 had epilepsy. Major deficits in cognitive function were found in 4 older children. One patient with normal development showed only a localized temporal lobe lesion on MRI and unremarkable MRA. Children with marked disorders of motor and cognitive development had defects of temporo-parietal lobes, basal ganglia, thalamus and internal capsule on MRI and recanalization of the middle cerebral artery shown on MRA. Those without recanalization had a poorer prognosis. [1]

COMMENT. Magnetic resonance angiography (MRA) images intracranial blood vessels without necessity for invasive contrast media. Children with neonatal stroke, seizures, and abnormalities shown on MRA have severe cognitive delays and the least favorable prognosis on long-term follow up.