Abnormal neurodevelopmental outcomes are very likely in cases of bilateral neonatal arterial ischaemic stroke.
OBJECTIVE
Neonatal arterial ischaemic stroke (AIS) is an important cause of severe neurological disability. This study aimed to analyse the clinical manifestations and outcomes of AIS patients.


METHODS
We enrolled neonates with AIS admitted to Severance Children's Hospital and Gangnam Severance Hospital between 2008 and 2015. AIS was confirmed using magnetic resonance imaging (MRI). We retrospectively reviewed the clinical manifestations, MRI findings, electroencephalography (EEG) findings and neurodevelopmental outcomes.


RESULTS
The study comprised 29 neonates (18 boys). The mean follow-up period was 15.4 months (range 6-44 months), and the mean age at diagnosis was 8.1 days. Seizure was the most common symptom (66%). Bilateral involvement was more common than unilateral involvement (52%). The middle cerebral artery was the most commonly identified territory (79%). Abnormal EEG findings were noted in 93% of the cases. Neurodevelopment was normal in 11 (38%) patients, while cerebral palsy and delayed development were noted in eight (28%) and six (21%) patients, respectively. Patients with bilateral involvement were very likely to have abnormal neurodevelopmental outcomes.


CONCLUSIONS
Our study showed that abnormal neurodevelopmental outcomes were very likely after cases of neonatal AIS with bilateral involvement, and clinicians should consider early and more effective interventions in such cases.
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ju Hyun
JH
Jin
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Jeong Eun
JE
Shin
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Soon Min
SM
Lee
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ho Seon
HS
Eun
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Min Soo
MS
Park
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Kook In
KI
Park
Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
Ran
R
Namgung
D002544:Cerebral Infarction / Q000150:complications* / Q000000981:diagnostic imaging; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D065886:Neurodevelopmental Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D059906:Neuroimaging; D012189:Retrospective Studies
Abnormal neurodevelopmental outcome; Arterial ischaemic stroke; Bilateral involvement; Cerebral palsy; Delayed development