Multimodal Outcome at 7 Years of Age after Neonatal Arterial Ischemic Stroke

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• 作者：Sté ; phane Chabrier ; MD¹ ; ² ; ^{stephane.chabrier@chu-st-etienne.fr" class="auth_mail" title="E-mail the corresponding author} ; Emeline Peyric ; MSc¹ ; Laure Drutel ; MSc¹ ; Johanna Deron ; MSc¹ ; Manoë ; lle Kossorotoff ; MD ; PhD³ ; ⁴ ; Mickaë ; l Dinomais ; MD ; PhD⁵ ; ⁶ ; Leila Lazaro ; MD⁷ ; Jé ; ré ; mie Lefranc ; MD⁸ ; Guillaume Thé ; bault ; MSc² ; ⁹ ; Gé ; rard Dray ; PhD¹⁰ ; Joel Fluss ; MD¹¹ ; Cyrille Renaud ; PhD¹ ; ² ; Sylvie Nguyen The Tich ; MD ; PhD⁶ ; ¹² ; on behalf of the Accident Vasculaire Cé ; ré ; bral du nouveau-né ; (AVCnn ; [Neonatal Stroke]) Study Group^&lowast ; ; Sté ; phane Darteyre ; MD ; Cé ; line Dé ; gano ; MSc ; Matthieu Delion ; MD ; PhD ; Samuel Groeschel ; MD ; Lucie Hertz-Pannier ; MD ; PhD ; Bé ; atrice Husson ; MD ; Emilie Presles ; MSc ; Magaly Ravel ; MD ; Carole Vuillerot ; MD ; PhD
• 关键词：AVCnn ; Accident Vasculaire Cé ; ré ; bral du nouveau-né ; (neonatal stroke) ; BFMF ; Bimanual Fine Motor Function ; CP ; Cerebral palsy ; FSIQ ; Full-scale IQ ; GMFCS ; Gross Motor Function Classification Scale ; NAIS ; Neonatal arterial ischemic stroke ; PCA ; Principal component analysis ; PIS ; Perinatal ischemic stroke ; PRI ; Perceptual Reasoning Index ; PSI ; Processing Speed Index ; VCI ; Verbal Comprehension Index ; WISC-IV ; Wechsler Intelligence Scale for Children&ndash ; Fourth Edition ; WMI ; Wor
• 刊名：The Journal of Pediatrics
• 出版年：2016
• 出版时间：May 2016
• 年：2016
• 卷：172
• 期：Complete
• 页码：156-161.e3
• 全文大小：481 K

文摘

To evaluate the epileptic, academic, and developmental status at age 7 years in a large population of term-born children who sustained neonatal arterial ischemic stroke (NAIS), and to assess the co-occurrence of these outcomes.

Study design

A cohort study including 100 term newborns with NAIS was designed. Two infants died during the neonatal period, 13 families were lost to follow-up, and 5 families declined to participate in this evaluation. Thus, 80 families completed the 7-year clinical assessment. Epileptic status, schooling, motor abilities, global intellectual functioning, spoken language, and parental opinions were recorded. Principal component analysis was applied.

Results

Rates of impaired language, cerebral palsy, low academic skills, active epilepsy, and global intellectual deficiency were 49%, 32%, 28%, 11%, and 8%, respectively. All were highly correlated. Eventually, 59% of children were affected by at least 1 of the aforementioned conditions. In 30% of cases, the viewpoints of health practitioners and parents did not match.

Conclusion

The prevalence of severe disabilities at 7 years after NAIS is low, but most children exhibit some impairment in developmental profile.

Trial registration

ClinicalTrials.gov (NCT02511249), Programme Hospitalier de Recherche Clinique Régional (0308052), Programme Hospitalier de Recherche Clinique Interrégional (1008026), and EudraCT (2010-A00329-30).