The role of brain territorial involvement and infection/inflammation in the long-term outcome of neonates with arterial ischemic stroke: A population-based cohort study
| Autor: | Istvan Seri, Agnes Jermendy, Gábor Rudas, Eszter Vojcek, Rozsa Graf, Anna M. László, Marianne Berenyi |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Pediatrics
medicine.medical_specialty Population Inflammation Bayley Scales of Infant Development Cerebral palsy Cohort Studies 03 medical and health sciences Epilepsy 0302 clinical medicine 030225 pediatrics Humans Medicine Child education Stroke Ischemic Stroke education.field_of_study business.industry Infant Newborn Brain Infant Obstetrics and Gynecology medicine.disease Child Preschool Pediatrics Perinatology and Child Health Corticospinal tract medicine.symptom business 030217 neurology & neurosurgery Cohort study |
| Zdroj: | Early Human Development. 158:105393 |
| ISSN: | 0378-3782 |
| DOI: | 10.1016/j.earlhumdev.2021.105393 |
| Popis: | Background Neonatal arterial ischemic stroke (NAIS) carries the risk of significant long-term neurodevelopmental burden on survivors. Aims To assess the long-term neurodevelopmental outcome of term neonates diagnosed with NAIS and investigate the associations among brain territorial involvement on MRI, clinical risk factors and neurodevelopmental outcomes. Study design Population-based cohort study. Subjects Seventy-nine term neonates with NAIS confirmed by MRI born between 2007 and 2017. Outcome measures Long-term neurodevelopmental outcome assessed using the Bayley Scales of Infant Development-II, the Brunet-Lezine test and the Binet Intelligence scales-V. Results Follow-up was available in 70 (89%) of the subjects enrolled, at a median age of 60 months [IQR: 35–84]. Normal neurodevelopmental outcome was found in 43% of the patients. In a multivariable model, infants with main MCA stroke had an increased risk for overall adverse outcome (OR: 9.1, 95% CI: 1.7–48.0) and a particularly high risk for cerebral palsy (OR: 55.9, 95% CI: 7.8–399.2). The involvement of the corticospinal tract without extensive stroke also increased the risk for cerebral palsy/fine motor impairment (OR: 13.5, 95% CI: 2.4–76.3). Multiple strokes were associated with epilepsy (OR: 9.5, 95% CI: 1.0–88.9) and behavioral problems (OR: 4.4, 95% CI: 1.1–17.5) and inflammation/infection was associated with cerebral palsy (OR: 9.8, 95% CI: 1.4–66.9), cognitive impairment (OR: 9.2, 95% CI: 1.8–47.8) and epilepsy (OR: 10.3, 95% CI: 1.6–67.9). Conclusions Main MCA stroke, involvement of the corticospinal tract, multiple strokes and inflammation/infection were independent predictors of adverse outcome, suggesting that the interplay of stroke territorial involvement and clinical risk factors influence the outcome of NAIS. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect