Impact of stroke volume on motor outcome in neonatal arterial ischemic stroke.


Journal

European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society
ISSN: 1532-2130
Titre abrégé: Eur J Paediatr Neurol
Pays: England
ID NLM: 9715169

Informations de publication

Date de publication:
Mar 2020
Historique:
received: 24 04 2019
revised: 22 09 2019
accepted: 29 10 2019
pubmed: 20 11 2019
medline: 1 9 2020
entrez: 20 11 2019
Statut: ppublish

Résumé

Neonatal arterial ischemic stroke (NAIS) can lead to long-term neurological consequences such as cerebral palsy (CP). The aim of this study was to evaluate the predictive value of acute diffusion-weighted imaging (DWI) for CP by analyzing stroke volume next to brain structure involvement. We included 37 term-born infants with NAIS prospectively registered in a nationwide pediatric stroke registry. DWI was performed between 0 and 8 days (mean 3 days) after stroke manifestation. Participants were neurologically assessed at the age of 2 years. We calculated the stroke volume (in mm Sixteen children (43.2%) developed CP. Relative stroke volume significantly predicted CP (p < .001). Its optimal threshold for division into high- and low-rate of CP was 3.3%. The basal ganglia (OR 8.3, 95% CI 1.2-60.0) and basis pontis (OR 18.5, 95% CI 1.8-194.8) were independently associated with CP. In addition to determining the involvement of affected brain areas, the volumetric quantification of stroke volume allows accurate prediction of cerebral palsy in newborns with NAIS.

Sections du résumé

BACKGROUND AND OBJECTIVES OBJECTIVE
Neonatal arterial ischemic stroke (NAIS) can lead to long-term neurological consequences such as cerebral palsy (CP). The aim of this study was to evaluate the predictive value of acute diffusion-weighted imaging (DWI) for CP by analyzing stroke volume next to brain structure involvement.
METHODS METHODS
We included 37 term-born infants with NAIS prospectively registered in a nationwide pediatric stroke registry. DWI was performed between 0 and 8 days (mean 3 days) after stroke manifestation. Participants were neurologically assessed at the age of 2 years. We calculated the stroke volume (in mm
RESULTS RESULTS
Sixteen children (43.2%) developed CP. Relative stroke volume significantly predicted CP (p < .001). Its optimal threshold for division into high- and low-rate of CP was 3.3%. The basal ganglia (OR 8.3, 95% CI 1.2-60.0) and basis pontis (OR 18.5, 95% CI 1.8-194.8) were independently associated with CP.
CONCLUSION CONCLUSIONS
In addition to determining the involvement of affected brain areas, the volumetric quantification of stroke volume allows accurate prediction of cerebral palsy in newborns with NAIS.

Identifiants

pubmed: 31740218
pii: S1090-3798(19)30395-2
doi: 10.1016/j.ejpn.2019.10.006
pii:
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

97-105

Investigateurs

Andrea Capone Mori (AC)
Sandra Bigi (S)
Alexandre Datta (A)
Joël Fluss (J)
Annette Hackenberg (A)
Elmar Keller (E)
Mark T MacKay (MT)
Olive Maier (O)
Danielle Mercati (D)
Jean-Pierre Marcoz (JP)
Claudia Poloni (C)
Gian Paolo Ramelli (GP)
Maria Regényi (M)
Regula Schmid (R)
Thomas Schmitt-Mechelke (T)

Informations de copyright

Copyright © 2019 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of Competing Interest The authors have no conflicts of interest relevant to this article to disclose.

Auteurs

Andreas Wiedemann (A)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland.

Manuela Pastore-Wapp (M)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland; Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.

Nedelina Slavova (N)

Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.

Leonie Steiner (L)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland.

Christian Weisstanner (C)

Support Center of Advanced Neuroimaging (SCAN), Institute for Diagnostic and Interventional Neuroradiology, Inselspital, Bern University Hospital, Bern, Switzerland.

Mária Regényi (M)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland.

Maja Steinlin (M)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland.

Sebastian Grunt (S)

Division of Neuropediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland. Electronic address: Sebastian.Grunt@insel.ch.

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