Incidence and outcomes of symptomatic neonatal arterial ischemic stroke.

Grunt, Sebastian; Mazenauer, Lea; Bürki, Sarah Elisabeth; Boltshauser, Eugen; Mori, Andrea Capone; Datta, Alexandre N; Fluss, Joël; Mercati, Danielle; Keller, Elmar; Maier, Oliver; Poloni, Claudia; Ramelli, Gian-Paolo; Schmitt-Mechelke, Thomas; Steinlin, Maja (2015). Incidence and outcomes of symptomatic neonatal arterial ischemic stroke. Pediatrics, 135(5), e1220-e1228. American Academy of Pediatrics 10.1542/peds.2014-1520

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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.

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

UniBE Contributor:

Grunt, Sebastian; Bürki, Sarah Elisabeth and Steinlin, Maja

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0031-4005

Publisher:

American Academy of Pediatrics

Language:

English

Submitter:

André Schaller

Date Deposited:

08 Apr 2016 13:10

Last Modified:

11 Apr 2016 15:01

Publisher DOI:

10.1542/peds.2014-1520

PubMed ID:

25896840

Uncontrolled Keywords:

cerebral palsy; epidemiology; neonate; outcome; stroke

BORIS DOI:

10.7892/boris.79372

URI:

https://boris.unibe.ch/id/eprint/79372

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