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世界核心医学期刊文摘(神经病学分册) 2006年第10期 61-62页

作者： Pavese N. Gerhard A. P. Piccini 朱振中 hammersmith hospital cyclotron bldg. ducane road w12 0nn london united kingdom dr.

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新生儿和儿童大脑中动脉卒中后的MRI结果与偏瘫症状的关系

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世界核心医学期刊文摘（儿科学分册） 2006年第6期2卷 59-60页

作者： Boardman J.P. Ganesan V. Rutherford M.A. 高蕊 Imaging Sciences Department Imperial College London Hammersmith Hospital Campus DuCane Road London W12 0HS United Kingdom

Objective. Motor impairment after neonatal and childhoodonset ischemic stroke (IS) is common, although the prevalence and type of hemiparesis differs between the 2 age groups. Lesion topography is an important predictor of hemiparesis after neonatal IS, but it is not known if the same topographic predictors of adverse motor outcome apply to childhood-onset IS. we used a consistent approach to define lesion topography and evaluate motor outcome in both age groups to (1) investigate whether early topographic predictors of hemiparesis after unilateral middle cerebral artery-territory stroke are the same in neonates and older childr.n and (2) compare the prevalence of dystonia and loss of independent finger movements between the 2 age groups. Design. Twenty-eight patients with neonatal-onset IS (hammersmith hospital, london,united kingdom)were studied together with 43 patients with childhood-onset IS (Great Ormond Street hospital, london, united kingdom). All patients had exclusive unilateral middle cerebral artery-territory IS. Lesion topography was studied by using the first magnetic resonance image acquired after the onset of symptoms and was coded for involvement of cerebral cortex (CC), posterior limb of the internal capsule (PLIC), basal ganglia (BG), and white matter. The primary outcome was hemiparesis, and secondary outcomes were dystonia and loss of age-appropriate independent finger movements. Results. Hemiparesis was more common after childhood-onset IS (56%) than neonatalonset IS (24%). In neonatal-onset IS, concomitant involvement of BG, CC, and PLIC predicts the development of hemiparesis (odds ratio: 99; 95%confidence interval: 5.2-1883.8), and no child with 1 or 2 of these structures involved developed hemiparesis. In contrast, in childhood-onset IS, concomitant BG, CC, and PLIC lesions tended to be associated with hemiparesis (9 of 11), but this adverse outcome was seen also among patients with 1-or 2-site involvement. However, hemiparesis was less lik

关键词：大脑中动脉偏瘫症状新生儿卒中后儿童 MRI 缺血性卒中运动障碍缺血部位预示作用

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