Neurodevelopmental outcome of perinatal intracranial haemorrhage in patients born at term: A prospective study

被引:0
作者
Libzon, Stephanie [1 ,2 ]
Shiran, Shelly I. [3 ,4 ]
Fattal-Valevski, Aviva [1 ,4 ]
Schneebaum-Sender, Nira [1 ,4 ]
Roth, Jonathan [4 ,5 ,6 ]
Constantini, Shlomi [4 ,5 ,6 ]
Malinger, Gustavo [4 ,7 ]
Haratz, Karina Krajden [4 ,7 ]
Sira, Liat Ben [3 ,4 ]
Hausman-Kedem, Moran [1 ,4 ]
机构
[1] Tel Aviv Med Ctr & Sch Med, Dana Dwek Childrens Hosp, Pediat Neurol Inst, 6 Weizmann St, IL-6423906 Tel Aviv, Israel
[2] Tel Aviv Univ, Fac Med, Sch Hlth Profess, Dept Phys Therapy, Tel Aviv, Israel
[3] Dana Dwek Childrens Hosp, Tel Aviv Med Ctr, Dept Radiol, Div Pediat Radiol, Tel Aviv, Israel
[4] Tel Aviv Univ, Fac Med & Hlth Sci, Tel Aviv, Israel
[5] Tel Aviv Med Ctr & Sch Med, Pediat Neurosurg Dept, Tel Aviv, Israel
[6] Tel Aviv Med Ctr & Sch Med, Pediat Brain Ctr, Tel Aviv, Israel
[7] Tel Aviv Med Ctr & Sch Med, Lis Matern & Womens Hosp, Div Ultrasound Obstet & Gynecol, Tel Aviv, Israel
关键词
ARTERIAL ISCHEMIC-STROKE; INTRAVENTRICULAR HEMORRHAGE; PRETERM INFANTS; PREDICTORS; CHILDHOOD; AGE; COHORT; FETAL;
D O I
10.1111/dmcn.16310
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
AimTo assess the neurological and neurodevelopmental outcome of infants born at term with perinatal intracranial haemorrhage (pICH) and examine the clinical and neuroimaging associations.MethodA prospective, consecutive, single-center observational study of longitudinally followed children with pICH identified in the fetal or neonatal period (<= 28 days of life) between January 2014 and November 2022. Neurodevelopmental outcome was rated using the Pediatric Stroke Outcome Measure (PSOM) and the modified Rankin Scale (mRS).ResultsSixty-eight infants were included (67.6% diagnosed postnatally and 32.4% diagnosed antenatally). Intraventricular haemorrhage was the most common bleeding type (n = 43, 63.2%) and was more common in infants diagnosed prenatally (p = 0.004). Twenty-nine (42.6%) infants were diagnosed with cerebral palsy and 19.1% with remote epilepsy. PSOM was performed at a median age of 3 years 8 months (range = 1 year-9 years 5 months). According to the PSOM, outcome was normal in 29 (42.6%) infants. Twelve (17.6%) patients had mild impairment, 11 (16.2%) had moderate impairment, and 16 (23.5%) had severe impairment. There was no difference in neurological outcomes between patients diagnosed antenatally or postnatally. Remote epilepsy (p = 0.002), multi-compartment ICH (p = 0.048), vermian hemorrhage (p = 0.048), posthaemorrhagic ventricular dilatation (p = 0.037), thalamic volume loss (p = 0.037), white matter loss (p = 0.048), Wallerian degeneration (p = 0.026), and abnormal myelination in the posterior limb of the internal capsule (p = 0.005), were associated with less favourable PSOM scores. Anterior horn width correlated with PSOM total scores (r = 0.6).InterpretationpICH carries a significant risk of long-term adverse neurological outcomes with no difference in neurological outcome between those diagnosed antenatally or postnatally. Epilepsy and neuroradiological markers are associated with unfavourable neurodevelopmental outcomes.
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页数:14
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