PMID- 31952959
OWN - NLM
STAT- MEDLINE
DCOM- 20210325
LR  - 20210402
IS  - 1873-5150 (Electronic)
IS  - 0887-8994 (Print)
IS  - 0887-8994 (Linking)
VI  - 105
DP  - 2020 Apr
TI  - Outcome Trajectories after Primary Perinatal Hemorrhagic Stroke.
PG  - 41-47
LID - S0887-8994(19)30957-9 [pii]
LID - 10.1016/j.pediatrneurol.2019.11.019 [doi]
AB  - BACKGROUND: Perinatal hemorrhagic stroke in late preterm and term neonates is 
      understudied. We describe two-month and two-year neurological outcomes in a 
      prospective cohort. METHODS: Neonates >/=36 weeks' gestation with spontaneous 
      hemorrhagic stroke (parenchymal and intraventricular) presenting at age </=28 days 
      were enrolled between March 2007 and May 2015 at three tertiary pediatric 
      centers. Hemorrhagic transformation of arterial ischemic stroke or cerebral 
      sinovenous thrombosis was excluded. The Pediatric Stroke Outcome Measure (PSOM) 
      assessed outcomes. Wilcoxon signed-rank tests evaluated change over time. 
      RESULTS: Twenty-six neonates were included (median age: 1 day, interquartile 
      range [IQR] 0 to 16; median gestational age: 38.3 weeks, IQR 37.0 to 39.0). 
      Hemorrhage was isolated intraventricular in seven (27%), isolated 
      intraparenchymal in six (23%), and a combination in 10 (39%). Three neonates 
      (12%) died during hospitalization; one died later due to cardiac disease. Among 
      22 survivors, outcomes were assessed at a median of 2.1 months (IQR 1.7 to 3.3) 
      in 96% and 1.9 years (IQR 1.3 to 2.0) in 73%. Median PSOM scores were 0.0 (IQR 
      0.0 to 1.0) and 0.25 (IQR 0.0 to 1.3), respectively. At two years, 45% of 
      patients had no or nonimpairing deficits (PSOM <1.0), 30% had mild deficits (PSOM 
      1.0 to 2.0), and 5% had moderate deficits (PSOM 2.5 to 4.5). Over time, 31% 
      worsened and 6% improved. Although total PSOM scores did not change significantly 
      (P = 0.08), language subscores worsened (P = 0.009). No child developed epilepsy. 
      CONCLUSIONS: Perinatal hemorrhagic stroke survivors had favorable outcomes in 
      early childhood; at two years moderate to severe deficits occurred in 5%. 
      Language deficits may emerge over time, warranting close follow-up.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Porcari, Giulia S
AU  - Porcari GS
AD  - Division of Child Neurology, Department of Neurology, Children's Hospital of 
      Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 
      Philadelphia, Pennsylvania; Division of Child Neurology, Department of 
      Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at 
      the University of Pennsylvania, Philadelphia, Pennsylvania; Division of Pediatric 
      Neurology, Department of Pediatrics, Vanderbilt University Medical Center, 
      Nashville, Tennessee.
FAU - Jordan, Lori C
AU  - Jordan LC
AD  - Division of Pediatric Neurology, Department of Pediatrics, Vanderbilt University 
      Medical Center, Nashville, Tennessee.
FAU - Ichord, Rebecca N
AU  - Ichord RN
AD  - Division of Child Neurology, Department of Neurology, Children's Hospital of 
      Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 
      Philadelphia, Pennsylvania; Division of Child Neurology, Department of 
      Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at 
      the University of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Licht, Daniel J
AU  - Licht DJ
AD  - Division of Child Neurology, Department of Neurology, Children's Hospital of 
      Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 
      Philadelphia, Pennsylvania; Division of Child Neurology, Department of 
      Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at 
      the University of Pennsylvania, Philadelphia, Pennsylvania.
FAU - Smith, Sabrina E
AU  - Smith SE
AD  - Department of Pediatric Neurology, Kaiser Permanente Oakland Medical Center, 
      Oakland, California.
FAU - Beslow, Lauren A
AU  - Beslow LA
AD  - Division of Child Neurology, Department of Neurology, Children's Hospital of 
      Philadelphia, Perelman School of Medicine at the University of Pennsylvania, 
      Philadelphia, Pennsylvania; Division of Child Neurology, Department of 
      Pediatrics, Children's Hospital of Philadelphia, Perelman School of Medicine at 
      the University of Pennsylvania, Philadelphia, Pennsylvania. Electronic address: 
      beslow@email.chop.edu.
LA  - eng
GR  - K23 NS062110/NS/NINDS NIH HHS/United States
GR  - K24 HL147017/HL/NHLBI NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
DEP - 20191209
PL  - United States
TA  - Pediatr Neurol
JT  - Pediatric neurology
JID - 8508183
SB  - IM
MH  - Child, Preschool
MH  - Female
MH  - Follow-Up Studies
MH  - Hemorrhagic Stroke/complications/*pathology/*physiopathology/therapy
MH  - Humans
MH  - Infant
MH  - Infant, Newborn
MH  - Infant, Newborn, Diseases/*pathology/*physiopathology/therapy
MH  - Language Disorders/etiology
MH  - Male
MH  - *Outcome Assessment, Health Care
PMC - PMC7071982
MID - NIHMS1546158
OTO - NOTNLM
OT  - Outcomes
OT  - Perinatal hemorrhagic stroke
OT  - Seizure
OT  - Term newborn
EDAT- 2020/01/19 06:00
MHDA- 2021/03/26 06:00
PMCR- 2021/04/01
CRDT- 2020/01/19 06:00
PHST- 2019/08/18 00:00 [received]
PHST- 2019/11/16 00:00 [revised]
PHST- 2019/11/21 00:00 [accepted]
PHST- 2020/01/19 06:00 [pubmed]
PHST- 2021/03/26 06:00 [medline]
PHST- 2020/01/19 06:00 [entrez]
PHST- 2021/04/01 00:00 [pmc-release]
AID - S0887-8994(19)30957-9 [pii]
AID - 10.1016/j.pediatrneurol.2019.11.019 [doi]
PST - ppublish
SO  - Pediatr Neurol. 2020 Apr;105:41-47. doi: 10.1016/j.pediatrneurol.2019.11.019. 
      Epub 2019 Dec 9.