Delayed neurological signs following isolated parasagittal injury in asphyxia at term
Delayed neurological signs following isolated parasagittal injury in asphyxia at term
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DOI：
10.1016/j.ejpn.2007.10.003
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发表时间：
2008-09-01
影响因子：
3.1
通讯作者：
Kojima, Seiji
中科院分区：
文献类型：
--
作者：
Sato, Yoshiaki;Hayakawa, Masahiro;Kojima, Seiji
背景：矢状旁脑损伤是足月婴儿的一种脑损伤，以大脑前、中、后动脉边界区损伤为主，但其早期临床表现多不明确。目的：了解矢状旁脑损伤的早期临床特点。方法：对18例诊断为矢状旁脑损伤的新生儿的MRI临床资料进行分析。11名婴儿在矢状旁区有局限性损伤（“有限”组），7名婴儿有弥漫性广泛损伤，涉及深部灰质和/或心室周围白质（“广泛”组）。这些婴儿与9名围产期窒息无MRI异常的婴儿（“正常”组）进行比较。结果：三组患者在心电图异常率、低Apgar评分率、低血pH值及碱性超标率、机械通气需氧量等方面均无显著差异。与正常组相比，限制组在出生后一小时内发生新生儿脑病的婴儿较少。局限性组和广泛性组的新生儿癫痫发作更为频繁。肝和/或肾功能不全在有限组更常见。脑瘫和/或智力低下在广泛组中很常见。脑皮层电抑制在广泛组更为明显。在有限组（33%）和广泛组（60%）的婴儿中，电皮层活动的进行性抑制很常见。结论：副矢状突脑损伤患儿在出生后不久出现了严重的神经系统异常，但其生理和神经系统表现并不严重，提示对窒息患儿进行仔细的纵向观察的重要性。(C) 2007年欧洲儿科神经病学学会。Elsevier Ltd.出版。版权所有。
Background: Parasagittal cerebral injury is a type of cerebral injury in term infants, which is characterized by the predominant injury of the arterial border zones of the anterior, middle and posterior cerebral arteries, however its early clinical manifestation is mostly unclear.Aim: To understand early clinical features of parasagittal cerebral injury.Methods: The clinical details of 18 newborn infants who were diagnosed as having parasagittal cerebral injury on magnetic resonance imaging (MRI). Eleven infants had localized injury within parasagittal regions ("Limited" group), 7 infants had diffuse extensive injury involving the deep gray matter and/or periventricular white matter ("Extensive" group). These infants were compared with 9 infants with perinatal asphyxia without MRI abnormalities ("Normal" group).Results: There was no significant difference in the rate of cardiotocographic abnormalities, low Apgar scores, low blood pH and base excess, and the requirement for mechanical ventilation among three groups. Compared with the Normal group, fewer infants in the Limited group developed neonatal encephalopathy within an hour after birth. Neonatal seizures were more frequent in the Limited and the Extensive groups. Hepatic and/or renal dysfunction was more often observed in the Limited group. Cerebral palsy and/or mental retardation were common in the Extensive group. Electro-cortical depression was more in the Extensive group. Progressive suppression of electro-cortical activity was common within infants in the Limited group (33%) and the Extensive group (60%).Conclusion: Infants with parasagittal cerebral injury developed serious neurological abnormalities despite less serious physiological and neurological manifestation shortly after birth suggesting the importance of careful longitudinal observation of asphyxiated infants. (C) 2007 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.