Sebastian Grunt1, Lea Mazenauer2, Sarah E Buerki2, Eugen Boltshauser3, Andrea Capone Mori4, Alexandre N Datta5, Joël Fluss6, Danielle Mercati7, Elmar Keller8, Oliver Maier9, Claudia Poloni10, Gian-Paolo Ramelli11, Thomas Schmitt-Mechelke12, Maja Steinlin2. 1. Department of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland; sebastian.grunt@insel.ch. 2. Department of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital, Inselspital, Bern, Switzerland; 3. Department of Neuropaediatrics, University Children's Hospital, Zurich, Switzerland; 4. Department of Neuropaediatrics, Children's Hospital, Aarau, Switzerland; 5. Department of Neuropaediatrics, University Children's Hospital, Basel, Switzerland; 6. Neuropaediatrics, Paediatric Subspecialties Service, University Children's Hospital, Geneva, Switzerland; 7. Champreveyres 4, Neuchâtel, Switzerland; 8. Department of Neuropaediatrics, Children's Hospital, Chur, Switzerland; 9. Department of Neuropaediatrics, Children's Hospital, St Gallen, Switzerland; 10. Department of Neuropaediatrics, University Children's Hospital, Lausanne, Switzerland; 11. Department of Paediatrics, Children's Hospital, Bellinzona, Switzerland; and. 12. Department of Neuropaediatrics, Children's Hospital, Lucerne, Switzerland.
Abstract
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.
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.
Authors: Renée A Shellhaas; Taeun Chang; Courtney J Wusthoff; Janet S Soul; Shavonne L Massey; Catherine J Chu; M Roberta Cilio; Sonia L Bonifacio; Nicholas S Abend; Tammy N Tsuchida; Hannah C Glass Journal: J Pediatr Date: 2016-11-07 Impact factor: 4.406
Authors: Barbara Goeggel Simonetti; Mubeen F Rafay; Melissa Chung; Warren D Lo; Lauren A Beslow; Lori L Billinghurst; Christine K Fox; Alberto Pagnamenta; Maja Steinlin; Mark T Mackay Journal: Neurology Date: 2019-12-19 Impact factor: 9.910
Authors: Lori L Billinghurst; Lauren A Beslow; Nicholas S Abend; Michael Uohara; Laura Jastrzab; Daniel J Licht; Rebecca N Ichord Journal: Neurology Date: 2017-01-13 Impact factor: 9.910