Incidence and outcomes of symptomatic neonatal arterial ischemic stroke.

Abstract:

BACKGROUND AND OBJECTIVES:Neonatal arterial ischemic stroke (NAIS) is associated with considerable lifetime burdens such as cerebral palsy, epilepsy, and cognitive impairment. Prospective epidemiologic studies that include outcome assessments are scarce. This study aimed to provide information on the epidemiology, clinical manifestations, infarct characteristics, associated clinical variables, treatment strategies, and outcomes of NAIS in a prospective, population-based cohort of Swiss children. METHODS:This prospective study evaluated the epidemiology, clinical manifestations, vascular territories, associated clinical variables, and treatment of all full-term neonates diagnosed with NAIS and born in Switzerland between 2000 and 2010. Follow-up was performed 2 years (mean 23.3 months, SD 4.3 months) after birth. RESULTS:One hundred neonates (67 boys) had a diagnosis of NAIS. The NAIS incidence in Switzerland during this time was 13 (95% confidence interval [CI], 11-17) per 100,000 live births. Seizures were the most common symptom (95%). Eighty-one percent had unilateral (80% left-sided) and 19% had bilateral lesions. Risk factors included maternal risk conditions (32%), birth complications (68%), and neonatal comorbidities (54%). Antithrombotic and antiplatelet therapy use was low (17%). No serious side effects were reported. Two years after birth, 39% were diagnosed with cerebral palsy and 31% had delayed mental performance. CONCLUSIONS:NAIS in Switzerland shows a similar incidence as other population-based studies. About one-third of patients developed cerebral palsy or showed delayed mental performance 2 years after birth, and children with normal mental performance may still develop deficits later in life.

journal_name

Pediatrics

journal_title

Pediatrics

authors

Grunt S,Mazenauer L,Buerki SE,Boltshauser E,Mori AC,Datta AN,Fluss J,Mercati D,Keller E,Maier O,Poloni C,Ramelli GP,Schmitt-Mechelke T,Steinlin M

doi

10.1542/peds.2014-1520

subject

Has Abstract

pub_date

2015-05-01 00:00:00

pages

e1220-8

issue

5

eissn

0031-4005

issn

1098-4275

pii

peds.2014-1520

journal_volume

135

pub_type

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