Header

UZH-Logo

Maintenance Infos

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


Abstract

BACKGROUND AND OBJECTIVES:

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:

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 mm3) and the ratio of the stroke volume to the volume of the entire brain (relative stroke volume). The predictive value of the relative stroke volume was analyzed and an optimal threshold for classification of children with high- and low-rates of CP was calculated. Predictive value of brain structure involvements and the prevalence of CP in combinations of different brain structures was also assessed.
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:

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.

Abstract

BACKGROUND AND OBJECTIVES:

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:

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 mm3) and the ratio of the stroke volume to the volume of the entire brain (relative stroke volume). The predictive value of the relative stroke volume was analyzed and an optimal threshold for classification of children with high- and low-rates of CP was calculated. Predictive value of brain structure involvements and the prevalence of CP in combinations of different brain structures was also assessed.
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:

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.

Statistics

Citations

Dimensions.ai Metrics

Altmetrics

Additional indexing

Contributors:Swiss Neuropediatric Stroke Registry Group
Item Type:Journal Article, refereed, original work
Communities & Collections:04 Faculty of Medicine > University Children's Hospital Zurich > Medical Clinic
Dewey Decimal Classification:610 Medicine & health
Uncontrolled Keywords:Pediatrics, Perinatology, and Child Health, Clinical Neurology, General Medicine
Language:English
Date:1 March 2020
Deposited On:06 Feb 2020 08:31
Last Modified:02 Apr 2020 01:06
Publisher:Elsevier
ISSN:1090-3798
OA Status:Closed
Publisher DOI:https://doi.org/10.1016/j.ejpn.2019.10.006
PubMed ID:31740218

Download

Full text not available from this repository.
View at publisher

Get full-text in a library