Impact of stroke volume on motor outcome in neonatal arterial ischemic stroke.

Wiedemann, Andreas; Pastore-Wapp, Manuela; Slavova, Nedelina; Steiner, Leonie; Weisstanner, Christian; Regényi, Mária; Steinlin, Maja; Grunt, Sebastian (2020). Impact of stroke volume on motor outcome in neonatal arterial ischemic stroke. European journal of paediatric neurology, 25, pp. 97-105. Elsevier 10.1016/j.ejpn.2019.10.006

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BACKGROUND AND OBJECTIVES Neonatal arterial ischemic stroke (NAIS) can lead to long-term neurological consequences such as cerebral palsy (CP). The aim of this study was to evaluate the predictive value of acute diffusion-weighted imaging (DWI) for CP by analyzing stroke volume next to brain structure involvement. METHODS We included 37 term-born infants with NAIS prospectively registered in a nationwide pediatric stroke registry. DWI was performed between 0 and 8 days (mean 3 days) after stroke manifestation. Participants were neurologically assessed at the age of 2 years. We calculated the stroke volume (in mm3) and the ratio of the stroke volume to the volume of the entire brain (relative stroke volume). The predictive value of the relative stroke volume was analyzed and an optimal threshold for classification of children with high- and low-rates of CP was calculated. Predictive value of brain structure involvements and the prevalence of CP in combinations of different brain structures was also assessed. RESULTS Sixteen children (43.2%) developed CP. Relative stroke volume significantly predicted CP (p < .001). Its optimal threshold for division into high- and low-rate of CP was 3.3%. The basal ganglia (OR 8.3, 95% CI 1.2-60.0) and basis pontis (OR 18.5, 95% CI 1.8-194.8) were independently associated with CP. CONCLUSION In addition to determining the involvement of affected brain areas, the volumetric quantification of stroke volume allows accurate prediction of cerebral palsy in newborns with NAIS.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine
04 Faculty of Medicine > Department of Gynaecology, Paediatrics and Endocrinology (DFKE) > Clinic of Paediatric Medicine > Neuropaediatrics
04 Faculty of Medicine > Department of Radiology, Neuroradiology and Nuclear Medicine (DRNN) > Institute of Diagnostic and Interventional Neuroradiology

UniBE Contributor:

Wapp, Manuela; Slavova, Nedelina Bozhidarova; Steiner, Leonie Serena; Weisstanner, Christian; Regényi, Mária; Steinlin, Maja and Grunt, Sebastian

Subjects:

600 Technology > 610 Medicine & health

ISSN:

1090-3798

Publisher:

Elsevier

Language:

English

Submitter:

Martin Zbinden

Date Deposited:

11 Dec 2019 11:05

Last Modified:

21 May 2020 14:39

Publisher DOI:

10.1016/j.ejpn.2019.10.006

PubMed ID:

31740218

Uncontrolled Keywords:

Cerebral palsy (CP) Diffusion-weighted imaging (DWI) Neonatal arterial ischemic stroke (NAIS) Prognosis Stroke involvement Stroke volume

BORIS DOI:

10.7892/boris.135456

URI:

https://boris.unibe.ch/id/eprint/135456

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