Sreenan C, Bhargava R, Robertson C M
Division of Newborn Medicine, Royal Alexandra Hospital, Alberta, Edmundto, Canada.
J Pediatr. 2000 Sep;137(3):351-5. doi: 10.1067/mpd.2000.107845.
We evaluated the long-term neurodevelopmental outcome of cranial computed tomography (CT)-documented cerebral infarction in term neonates to ascertain factors that would help to predict the risk of subsequent neurodevelopmental sequelae in early childhood.
From 1983 to 1997, all surviving neonates from two level III neonatal intensive care units were prospectively identified and subsequently assessed in childhood. Clinical presentation was characterized by retrospective chart review and blinded re-reading of computed tomography (CT) scans. Perinatal events were compared with neurodevelopmental outcome.
Forty-six children were followed up for a mean of 42.1 months (range, 18-164 months). Neurodevelopmental outcome was normal in 15 and abnormal in 31. A single disability was present in 8, and multiple disabilities were present in 23. Cerebral palsy was present in 22 and cognitive impairment in 19. Abnormal findings on neurologic examination at discharge and seizures in the neonatal period were associated with the presence of one or more childhood disabilities. The site or laterality of the vascular distribution of the lesion on neonatal CT did not correlate with long-term outcome.
After cerebral infarction in the neonatal period, one third of term infants have normal long-term development. Neonatal seizure history and the findings on neurologic examination at discharge help in counseling parents about the possible long-term outcome of neonatal stroke.
我们评估了足月新生儿头颅计算机断层扫描（CT）记录的脑梗死的长期神经发育结局，以确定有助于预测幼儿期后续神经发育后遗症风险的因素。
从1983年至1997年，前瞻性地确定了两个三级新生儿重症监护病房所有存活的新生儿，并随后在儿童期进行评估。通过回顾性病历审查和对计算机断层扫描（CT）扫描进行盲法重新解读来确定临床表现特征。将围产期事件与神经发育结局进行比较。
对46名儿童进行了平均42.1个月（范围为18 - 164个月）的随访。15名儿童神经发育结局正常，31名异常。8名儿童存在单一残疾，23名存在多种残疾。22名儿童患有脑瘫，19名存在认知障碍。出院时神经系统检查异常及新生儿期癫痫发作与儿童期出现一种或多种残疾有关。新生儿CT上病变血管分布的部位或侧别与长期结局无关。
新生儿期脑梗死发生后，三分之一的足月婴儿长期发育正常。新生儿癫痫病史及出院时神经系统检查结果有助于向家长提供有关新生儿中风可能的长期结局的咨询。
