非围产期缺氧缺血性脑病-长期预后和临床放射学相关性

Brain disorders (Amsterdam, Netherlands) Pub Date : 2025-03-27 DOI:10.1016/j.dscb.2025.100217

Saraswathi Ramanathan , Prince Thakkar , Harshad Vanjare , Raji Thomas , George Tharion , Bijesh Yadav

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引用次数: 0

摘要

目的研究非围产期缺氧缺血性脑病（HIE）的长期预后，并探讨其临床预后与神经影像学表现的相关性。材料与方法回顾性图表复习和电话随访研究。101例筛查患者（在缺氧损伤后6个月内被诊断为“HIE”而入住住院康复机构）中，有72例患者的家庭成员被联系，并记录了当前的电话修改Rankin量表（mRS）。mRS 0 ~ 3分为临床预后良好，mRS 4 ~ 6分为临床预后不良。神经影像学检查（CT和MRI）由神经放射科医生检查。结果患者平均（SD）年龄为34.06岁（18.33岁）。1年生存率为84.7%（61/72例），重度残疾（mRS 5）者占78.6% （n = 48）。随访时，60例（83.3%）患者预后不良(mRS 6, 38.9%, n = 28；mRS 5, 31.9%, n = 23；mRS 4, 12.5%, n = 9)和12例患者（16.7%）有良好的临床结果（mRS 2和mRS 3）。结果良好的患者影像学正常或皮质下受累，无扩散限制。弥漫性皮质及深灰色受累、弥漫性皮质白质受累、小脑受累及脑干受累预后较差。结论83.3%的hie患者预后较差。MRI的局灶性表现可能比弥漫性表现预后稍好。

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Non-perinatal hypoxic ischemic encephalopathy – Long term outcome and clinico-radiological correlation

Objective

To study the long-term outcome of non-perinatal Hypoxic Ischemic Encephalopathy (HIE) and to co-relate clinical outcomes with neuroimaging findings.

Materials and Methods

Retrospective chart review and telephonic follow up study.

Family members of 72 patients, out of 101 screened patients (admitted to an inpatient rehabilitation facility with diagnosis of “HIE” within 6 months of hypoxic insult) were contactable and current telephonic modified Rankin Scale (mRS) was documented. mRS of 0–3 was considered as favorable clinical outcome and mRS of 4–6 as poor outcome. Neuroimaging (CT and MRI) were reviewed by a neuro-radiologist.

Results

The mean (SD) age was 34.06 (18.33) years. One year survival rate was 84.7 % (61/72 patients), with severe disability (mRS 5) in 78.6 % (n = 48) of survivors. At follow up, 60 patients (83.3 %) had poor outcome (mRS 6, 38.9 %, n = 28; mRS 5, 31.9 %, n = 23; mRS 4, 12.5 %, n = 9) and 12 patients (16.7 %) had favorable clinical outcome (mRS 2 and 3). Patients with favorable outcomes had normal imaging or subcortical involvement without diffusion restriction. Diffuse cortical and deep grey involvement, diffuse cortical white matter involvement, cerebellar involvement and brain stem involvement had worse prognosis.