Evaluation of perinatal arterial ischemic stroke patients: Underlying etiologic factors and long-term prognosis

IF 1.7 4区医学 Q4 CLINICAL NEUROLOGY

Brain & Development Pub Date : 2026-02-01 Epub Date: 2026-01-15 DOI:10.1016/j.braindev.2026.104501

Çisem Duman Kayar , Rıdvan Avcı , Fulya Kürekçi , Ceyda Öney Yılmaz , Ceyda Bayraktar Eltutan , Vugar Abbasaliyev , Serap Karaman , Mehmet Barbüroğlu , Hülya Maraş Genç , Edibe Pembegül Yıldız

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引用次数: 0

Abstract

Background

Perinatal arterial ischemic stroke (PAIS) is a major cause of long-term neurological impairments. Understanding its etiologic and prognostic factors is essential for improving outcomes.

Methods

A retrospective single-center study was conducted on children diagnosed with PAIS between 2008 and 2024. Clinical, imaging, and EEG data were analyzed to identify predictors of epilepsy and poor outcomes based on modified Rankin Scale (mRS) scores.

Results

A total of 44 patients (9 neonatal arterial ischemic stroke [NAIS], 35 Presumed perinatal arterial ischemic stroke [PPAIS]) with a mean follow-up of 6.49 years were included. Seizure was the first symptom in 45.5%, and focal motor deficit in 54.5%. The most affected artery was the middle cerebral artery (92%), particularly the M1 branch (36.4%). Cortical involvement was noted in 59.1%. Fourteen patients developed epilepsy; 14.2% were drug-resistant. Focal EEG slowing (odds ratio [OR] = 8.484, p = 0.019) and cortical involvement (OR = 6.857, p = 0.023) significantly predicted epilepsy. Poor mRS outcomes (≥3) were seen in 44.2%, and were associated with epilepsy (OR = 5.556, p = 0.016), EEG slowing (OR = 5.353, p = 0.035), and cortical involvement (OR = 7.467, p = 0.008).

Conclusions

Early EEG and MRI findings are crucial in predicting long-term prognosis in PAIS. Further multicenter studies are needed to validate and enhance outcomes.

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围生期动脉缺血性脑卒中患者的评估：潜在病因和长期预后

背景围产期动脉缺血性中风（PAIS）是导致长期神经功能损伤的主要原因。了解其病因和预后因素对改善预后至关重要。方法对2008 ~ 2024年诊断为PAIS的儿童进行回顾性单中心研究。对临床、影像学和脑电图数据进行分析，以确定基于改良兰金量表（mRS）评分的癫痫和不良预后的预测因素。结果共纳入44例患者，其中新生儿动脉缺血性卒中9例，围产期动脉缺血性卒中35例，平均随访6.49年。癫痫是45.5%的第一症状，54.5%为局灶性运动障碍。受影响最大的动脉为大脑中动脉（92%），尤其是M1分支（36.4%）。59.1%的患者有皮层受累。14例发生癫痫；14.2%耐药。局灶性脑电图减慢（优势比[OR] = 8.484, p = 0.019）和皮层受累（OR = 6.857, p = 0.023）与癫痫有显著相关性。44.2%的患者出现不良mRS结果（≥3），并与癫痫（OR = 5.556, p = 0.016）、脑电图减慢（OR = 5.353, p = 0.035）和皮层受累（OR = 7.467, p = 0.008）相关。结论早期脑电图和MRI表现对预测PAIS的远期预后至关重要。需要进一步的多中心研究来验证和增强结果。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Brain & Development 医学-临床神经学

CiteScore

3.60

自引率

0.00%

发文量

153

审稿时长

50 days

期刊介绍： Brain and Development (ISSN 0387-7604) is the Official Journal of the Japanese Society of Child Neurology, and is aimed to promote clinical child neurology and developmental neuroscience. The journal is devoted to publishing Review Articles, Full Length Original Papers, Case Reports and Letters to the Editor in the field of Child Neurology and related sciences. Proceedings of meetings, and professional announcements will be published at the Editor''s discretion. Letters concerning articles published in Brain and Development and other relevant issues are also welcome.