Motor Outcomes After Neonatal Arterial Ischemic Stroke Related to Early MRI Data in a Prospective Study
Motor Outcomes After Neonatal Arterial Ischemic Stroke Related to Early MRI Data in a Prospective Study
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DOI：
10.1542/peds.2009-3611
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发表时间：
2010-10-01
期刊：
影响因子：
8
通讯作者：
Chabrier, Stephane
中科院分区：
文献类型：
--
作者：
Husson, Beatrice;Hertz-Pannier, Lucie;Chabrier, Stephane
目的：我们的目的是在一个大型的，同质的，队列的新生儿（诊断前29天的生活）动脉缺血性中风（AIS）的运动结果相关的早期成像数据：从一个前瞻性队列的100名儿童与新生儿AIS，我们分析了MRI研究进行的第一个28天的生活中的80名婴儿在2岁时进行评估。结果：73例脑梗死累及大脑中动脉（MCA），其中12例累及皮质脊髓束（CST），1例累及大脑中动脉（MCA）。其中，50例为浅表性梗死，5例为深部梗死，18例为混合性梗死。24起案件涉及国家支助委员会。19例MCA梗死患者（26% [95%置信区间：16%-34%]）发生偏瘫。混合性梗死（P <0.0001）和CST受累（P <0.0001）是偏瘫的高度预测因素。与此相反，88%的儿童孤立的浅表MCA梗死没有表现出impairment.CONCLUSIONS：准确的预测运动的结果，可以从早期MRI扫描后新生儿AIS。在94%的病例中，没有CST的参与导致了正常的运动发育。66%的病例中CST受累导致先天性偏瘫。儿科2010;126：e912-e918
OBJECTIVE: We aimed to correlate early imaging data with motor outcomes in a large, homogeneous, cohort of infants with neonatal (diagnosed before 29 days of life) arterial ischemic stroke (AIS).METHODS: From a prospective cohort of 100 children with neonatal AIS, we analyzed the MRI studies performed within the 28 first days of life for 80 infants evaluated at 2 years of age. The relationships between infarction location and corticospinal tract (CST) involvement and motor outcomes were studiedRESULTS: Seventy-three infarctions involved the middle cerebral artery (MCA) territory. Of those, 50 were superficial infarctions, 5 deep infarctions, and 18 mixed infarctions. The CST was involved in 24 cases. Nineteen patients with MCA infarctions (26% [95% confidence interval: 16%-34%]) developed hemiplegia. Mixed infarctions (P < .0001) and CST involvement (P < .0001) were highly predictive of hemiplegia. In contrast, 88% of children with isolated superficial MCA infarctions did not exhibit impairment.CONCLUSIONS: Accurate prediction of motor outcomes can be obtained from early MRI scans after neonatal AIS. The absence of involvement of the CST resulted in normal motor development in 94% of cases. CST involvement resulted in congenital hemiplegia in 66% of cases. Pediatrics 2010;126:e912-e918