Abstract
Objective
This study aimed to characterize the cerebrospinal fluid (CSF) of infants with stroke
and compare those findings to the CSF of infants with bacterial meningitis and neither
condition in the first 14 postnatal days.
Study design
Cohort study of 30,092 infants who received a lumbar puncture in the first 14 postnatal
days discharged from >400 neonatal intensive care units from 1997 to 2020. CSF parameters
were compared between infants with stroke and bacterial meningitis using non-parametric
hypothesis testing and quantile regression.
Results
Compared to infants with bacterial meningitis, infants with stroke had a significantly
lower median protein concentration, higher median glucose concentration, higher median
red blood cell count, and higher median monocyte count. Using quantile regression
at the 75th percentile, infants with stroke had a significantly lower white blood
cell count, segmented neutrophil count, and lymphocyte count than infants with bacterial
meningitis.
Conclusion
This study addresses the paucity of literature describing the CSF of infants with
ischemic stroke. Knowledge of the differences in CSF parameters between infants with
stroke and meningitis may allow for faster recognition and intervention before CSF
culture results are available.
Key Points
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Neonatal stroke is a serious and morbid event.
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Neonatal stroke and meningitis can present similarly.
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The CSF of neonatal stroke is poorly described.
Keywords
infant - stroke - lumbar puncture - cerebrospinal fluid - meningitis
