- 作者：Anna Perez ; Susanne Ritter ; Barbara Brotschi ; Helene Werner ; Jon Caflisch ; Ernst Martin ; Beatrice Latal
- 关键词：CP ; Cerebral palsy ; HIE ; Hypoxic-ischemic encephalopathy ; MRI ; Magnetic resonance imaging ; ZNA ; Zurich Neuromotor Assessment
- 刊名：The Journal of Pediatrics
- 出版年：2013
- 出版时间：August, 2013
- 年：2013
- 卷：163
- 期：2
- 页码：454-459.e1
- 全文大小：413 K
Objectives
To determine the long-term neurodevelopmental outcome for children after hypoxic-ischemic encephalopathy (HIE) without major disability, and to examine neonatal injury patterns detected on cerebral magnetic resonance imaging (MRI) in relation to later deficits.Study design
Prospectively enrolled children with HIE and neonatal cerebral MRI data (n = 68) were examined at a mean age of 11.2 years (range, 8.2-15.7 years). Eleven children had a major disability (ie, cerebral palsy or mental retardation). Brain injury was scored according to the region and extent of injury.
Results
Children without major disability (n = 57) had lower full-scale and performance IQ scores compared with norms (P = .02 and .01, respectively), and the proportion of children with an IQ <85 was higher than expected (P = .04). Motor performance on the Zurich Neuromotor Assessment was affected in the pure motor, adaptive fine motor, and gross motor domains, as well as in the movement quality domain (all P < .001). Watershed injury pattern on neonatal MRI correlated with full-scale and verbal IQ scores (P = .006 and <.001, respectively), but neonatal MRI pattern did not correlate with motor performance in children without major disability.
Conclusion
Children who sustained neonatal HIE without major disability are at increased risk for long-term intellectual, verbal, and motor deficits. The severity of watershed injury is correlated with later intellectual performance. Long-term follow-up examinations are necessary for early detection of neurodevelopmental impairment and early initiation of adequate therapies.