Background: Studies evaluating long-term
neurologic outcomes following NAIS are scanty. We aimed to study the
emergence pattern of neurologic deficits following NAIS.
Methods: Neonates diagnosed with AIS were
prospectively enrolled and outcomes were evaluated using the validated
Pediatric Stroke Outcome Measure-Severity Classification Scheme. Neurologic
outcomes were classified as normal/mild, moderate or severe. Trend analysis
was conducted using Cochran-Armitage test. Results: A
total of 126 neonates (59% males) were followed for a median of 5.2 years
(IQR:3.4-6.4 years). The proportion of children classified as normal/mild
declined from 94% to 76% >5 years post-stroke (p<0.01). Moderate and
severe outcomes increased from 5% to 15% and 1% to 8% (p=0.01),
respectively. Sensorimotor, language and cognitive deficits emerged in 16%,
14%, and 17% of enrolled neonates, respectively. Of those who had
normal/mild outcomes at baseline, 83 remained stable throughout the study.
Improvement in neurologic outcomes was seen in 8 children. Thirty-five
neonates had emerging deficits at one point during follow-up. Congenital
heart disease predicted the emergence of deficits (odds ratio=3.3, 95%
confidence interval:1.01-10.5). Conclusions: Emerging
deficits following NAIS are not uncommon and can equally manifest in
sensorimotor, language or cognitive domains. Thus, long-term follow-up and
close monitoring of outcomes following NAIS is crucial.
B.2 Neurologic outcome trajectory following neonatal arterial ischemic
stroke (NAIS): A longitudinal observational study
