From Clinical Sciences (A.N.C., V.A., S.H., M.G., R.W.H., M.T.M., P.M.), Murdoch Children's Research Institute; University of Melbourne (A.N.C., V.A., S.H., M.G., R.W.H., M.T.M., P.M.); The Royal Children's Hospital (V.A., M.G., R.W.H., M.T.M., P.M.); Evelina London Children's Hospital (A.L.G.), Guy's & St Thomas' NHS Foundation Trust; and Institute of Psychology, Psychiatry & Neuroscience (A.L.G.), Kings College London, UK.
Neurology. 2018 Jan 30;90(5):e365-e372. doi: 10.1212/WNL.0000000000004906.
To evaluate the relationship between neurologic outcome at 1 month following diagnosis of pediatric arterial ischemic stroke (AIS) and motor and adaptive behavior outcomes at 12 months.
This prospective longitudinal observational cohort study recruited children from a single tertiary children's hospital diagnosed with first AIS between December 2007 and November 2013. Neurologic impairment was evaluated at 4 time points using the Pediatric Stroke Outcome Measure (PSOM) or Recovery and Recurrence Questionnaire following diagnosis of AIS (acute, 1, 6, and 12 months). Motor function and adaptive behavior were assessed at 12 months using standardized measures. Children were grouped for analysis, according to age at diagnosis (neonates vs preschool vs school-aged). The relationship between neurologic impairment and 12-month functional outcomes were examined.
Sixty-four children were recruited (27 neonates, 19 preschool-aged, and 18 school-aged). Presence of impairment on the PSOM at 1 month was associated with lower 12-month fine motor scores ( = 0.004), gross motor scores ( = 0.001), and adaptive behavior standard scores ( = 0.004). One-month PSOM impairment score was more predictive than age group or lesion size of 12-month motor and adaptive behavior outcome.
The PSOM has value as a predictive tool when used at 1 month after first AIS diagnosed acutely in relation to motor and adaptive behavior, with variation according to age group.
评估儿科动脉缺血性脑卒中（AIS）发病后 1 个月的神经功能预后与 12 个月时运动和适应行为预后之间的关系。
这项前瞻性纵向观察队列研究纳入了 2007 年 12 月至 2013 年 11 月期间在一家单所三级儿童医院首次诊断为 AIS 的儿童。使用儿科脑卒中结局测量量表（PSOM）或 AIS 发病后恢复和复发问卷（发病后 1、6 和 12 个月），在 4 个时间点评估神经损伤。使用标准化测量工具在 12 个月时评估运动功能和适应行为。根据发病时的年龄（新生儿、学龄前儿童和学龄儿童）对儿童进行分组分析。检验了神经损伤与 12 个月功能结局之间的关系。
共纳入 64 例儿童（新生儿 27 例，学龄前儿童 19 例，学龄儿童 18 例）。PSOM 在 1 个月时存在损伤与 12 个月时精细运动评分较低（ = 0.004）、粗大运动评分较低（ = 0.001）和适应行为标准评分较低（ = 0.004）有关。1 个月 PSOM 损伤评分比年龄组或病变大小更能预测 12 个月的运动和适应行为结局。
PSOM 在 AIS 急性发病后 1 个月使用时具有预测价值，与运动和适应行为有关，且因年龄组而异。
