title: Cortical Sparing in Preterm Ischemic Arterial Stroke.
abstract: OBJECTIVE
  Residual injury after perinatal arterial ischemic stroke in the middle cerebral artery territory usually involves the loss of cortical gray matter and subcortical white matter. In this article, we describe a different pattern of residual injury after middle cerebral artery stroke in preterm-born infants, in which the cortex is spared.
  
  
  METHODS
  Magnetic resonance imaging scans of 40 infants (12 preterm and 28 full-term infants) with a large middle cerebral artery stroke were reviewed and correlated with outcome.
  
  
  RESULTS
  Complete sparing of the cortex with cavitation of the underlying white matter was observed in 3 preterm infants, and partial sparing was noted in another 4 late preterm-born infants. One full-term infant had partial cortical sparing, and all others showed no sparing. Overall, 86% developed a hemiplegia and 30% had a developmental quotient below 85, but this did not vary between the different types of cortical injury.
  
  
  CONCLUSIONS
  The pattern of cortical injury after middle cerebral artery stroke changes with gestational age and may be related to maturational changes of the vascular system. Outcome did not vary between the different patterns of cortical injury.
authors.affiliation: From the Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands (N.E.v.d.A., M.J.N.L.B., F.G., L.S.d.V.); and Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands (P.G.N.). n.vanderaa@umcutrecht.nl.
authors.forename: Niek E
authors.initials: NE
authors.lastname: van der Aa
authors.affiliation: From the Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands (N.E.v.d.A., M.J.N.L.B., F.G., L.S.d.V.); and Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands (P.G.N.).
authors.forename: Manon J N L
authors.initials: MJ
authors.lastname: Benders
authors.affiliation: From the Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands (N.E.v.d.A., M.J.N.L.B., F.G., L.S.d.V.); and Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands (P.G.N.).
authors.forename: Peter G
authors.initials: PG
authors.lastname: Nikkels
authors.affiliation: From the Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands (N.E.v.d.A., M.J.N.L.B., F.G., L.S.d.V.); and Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands (P.G.N.).
authors.forename: Floris
authors.initials: F
authors.lastname: Groenendaal
authors.affiliation: From the Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands (N.E.v.d.A., M.J.N.L.B., F.G., L.S.d.V.); and Department of Pathology, University Medical Centre Utrecht, Utrecht, The Netherlands (P.G.N.).
authors.forename: Linda S
authors.initials: LS
authors.lastname: de Vries
mesh_terms: D002545:Brain Ischemia / Q000175:diagnosis* / Q000378:metabolism*; D002540:Cerebral Cortex / Q000378:metabolism*; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature / Q000378:metabolism*; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis* / Q000378:metabolism*; D008297:Male
keywords: magnetic resonance imaging; middle cerebral artery; perinatal arterial ischemic stroke; preterm birth; stroke