Harbert Mary J, Tam Emily W Y, Glass Hannah C, Bonifacio Sonia L, Haeusslein Laurel A, Barkovich A James, Jeremy Rita J, Rogers Elizabeth E, Glidden David V, Ferriero Donna M
Department of Neurosciences, University of California-San Diego, San Diego, CA 92123, USA.
J Child Neurol. 2011 Sep;26(9):1126-30. doi: 10.1177/0883073811408092. Epub 2011 Jun 23.
Within a single-center prospective cohort study of neonatal encephalopathy involving 315 subjects, 15 neonates were found to have a focal stroke on magnetic resonance imaging. These 15 patients were matched on the basis of gender and degree of encephalopathy to 30 neonates without stroke from the same cohort. On Bayley Scales of Infant Development, the stroke group had Mental Development Index scores that were 1.7 standard deviations lower compared with controls (P = .007). This association was no longer seen after adjustment for the presence of neonatal seizures (P = .11). Of the 15 patients with stroke, 5 had been treated with hypothermia. None of these 5 had seizures in the neonatal period, compared with 7 of the untreated 10. This is the first human study to demonstrate a potential treatment effect of therapeutic hypothermia on perinatal stroke. It was also shown that seizures are associated with worse cognitive outcomes for stroke that presents with encephalopathy.
在一项涉及315名受试者的单中心新生儿脑病前瞻性队列研究中，15名新生儿在磁共振成像检查中被发现有局灶性中风。这15名患者根据性别和脑病程度与同一队列中30名无中风的新生儿进行匹配。在贝利婴儿发育量表上，中风组的智力发育指数得分比对照组低1.7个标准差（P = 0.007）。在对新生儿惊厥的存在进行校正后，这种关联不再明显（P = 0.11）。在15名中风患者中，5名接受了低温治疗。这5名患者在新生儿期均未发生惊厥，而未接受治疗的10名患者中有7名发生了惊厥。这是第一项证明治疗性低温对围产期中风具有潜在治疗效果的人体研究。研究还表明，惊厥与伴有脑病的中风患者更差的认知结局相关。
