Coarse Tremor as the Only Sign of Perinatal Hemorrhagic Stroke: A Case Report

Document Type : Case Report


1 Neonatal Research Center, Shiraz University of Medical Science, Shiraz, Iran

2 Clinical Neurology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran


Background: Tremor which is the most common abnormal movement in the neonatal period might be a benign condition or the result of pathologic events and is divided into two subtypes, namely fine tremor and coarse tremor. Fine tremor is usually benign and results from some metabolic disturbance, such as hypoglycemia. On the other hand, coarse tremor is an indicator of brain insult and should be regarded as a central pathology comparable to intracranial hemorrhage and hypoxic-ischemic encephalopathy and requires further evaluations. Stroke is one of the most important associated pathologies that are readily missed in the neonatal period. The possibility of stroke should be suspected in all newborns in the presence of coarse tremor.
Case report: Here, we will present a newborn with perinatal hemorrhagic stroke who was in good condition after birth with Apgar score of 9 and normal vital signs, birth weight, head circumference, length, and primitive reflexes; however, he had coarse tremor in both upper extremities in physical examination as the only sign of the hemorrhagic stroke.
Conclusion: It is recommended that neonates with coarse tremor be investigated more carefully to rule out the structural brain pathology.


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