Golomb Meredith R, Dick Paul T, MacGregor Daune L, Curtis Rosalind, Sofronas Marianne, deVeber Gabrielle A
Department of Neurology, Division of Pediatric Neurology, Indiana University School of Medicine, Riley Hospital for Children, Room 1757, 702 Barnhill Drive, Indianapolis, IN 46202, USA.
J Child Neurol. 2004 Jul;19(7):493-7. doi: 10.1177/08830738040190070301.
The risk factors for arterial ischemic stroke and cerebral sinovenous thrombosis in neonates are not well understood. We looked at gender, birthweight, and gestational age in neonates with arterial ischemic stroke and cerebral sinovenous thrombosis to see if there were trends suggesting that these were risk factors. We identified neonates with a gestational age at birth > or = 36 weeks and a diagnosis of arterial ischemic stroke or cerebral sinovenous thrombosis made by computed tomography or magnetic resonance imaging during the neonatal period from a consecutive cohort study of children with arterial ischemic stroke and cerebral sinovenous thrombosis in Ontario. Data on gender, birthweight, and gestational age were obtained by health record review. Sixty-six children with neonatal arterial ischemic stroke were identified. Forty-one (62.1%; 95% CI 49.3-73.8%) were male. Thirty-two children with neonatal cerebral sinovenous thrombosis were identified. Twenty-five (78.1%; 95% CI 60.0-90.7%) were male. One male child was identified with both arterial ischemic stroke and cerebral sinovenous thrombosis. There was a trend toward higher than average birthweights among neonates with arterial ischemic stroke and a trend toward older gestational age in female neonates with arterial ischemic stroke. Our data suggest that neonatal arterial ischemic stroke and cerebral sinovenous thrombosis are more commonly diagnosed in boys. The slightly larger size of male neonates may be contributory in arterial ischemic stroke. It is not known whether boys are at higher risk of developing arterial ischemic stroke and cerebral sinovenous thrombosis or are simply more likely to present with symptoms resulting in diagnosis. These issues need further study.
新生儿动脉缺血性卒中及脑静脉窦血栓形成的危险因素尚未完全明确。我们研究了患有动脉缺血性卒中和脑静脉窦血栓形成的新生儿的性别、出生体重和胎龄,以观察是否存在表明这些因素为危险因素的趋势。我们从安大略省一项关于儿童动脉缺血性卒中和脑静脉窦血栓形成的连续队列研究中,确定了出生时胎龄≥36周、在新生儿期经计算机断层扫描或磁共振成像诊断为动脉缺血性卒中和脑静脉窦血栓形成的新生儿。通过查阅健康记录获取性别、出生体重和胎龄的数据。共识别出66例新生儿动脉缺血性卒中患儿。其中41例(62.1%;95%可信区间49.3 - 73.8%)为男性。共识别出32例新生儿脑静脉窦血栓形成患儿。其中25例(78.1%;95%可信区间60.0 - 90.7%)为男性。有1例男童同时患有动脉缺血性卒中和脑静脉窦血栓形成。患有动脉缺血性卒中的新生儿出生体重有高于平均水平的趋势,患有动脉缺血性卒中的女婴胎龄有偏大的趋势。我们的数据表明,新生儿动脉缺血性卒中和脑静脉窦血栓形成在男孩中更常见。男性新生儿稍大的体型可能与动脉缺血性卒中有关。尚不清楚男孩是发生动脉缺血性卒中和脑静脉窦血栓形成的风险更高,还是仅仅更有可能出现导致诊断的症状。这些问题需要进一步研究。