BACKGROUND AND OBJECTIVES Neonatal arterial ischemic stroke (NAIS) can lead to long-term neurological consequences such as cerebral palsy (CP). The aim of this study was to evaluate the predictive value of acute diffusion-weighted imaging (DWI) for CP by analyzing stroke volume next to brain structure involvement. METHODS We included 37 term-born infants with NAIS prospectively registered in a nationwide pediatric stroke registry. DWI was performed between 0 and 8 days (mean 3 days) after stroke manifestation. Participants were neurologically assessed at the age of 2 years. We calculated the stroke volume (in mm3) and the ratio of the stroke volume to the volume of the entire brain (relative stroke volume). The predictive value of the relative stroke volume was analyzed and an optimal threshold for classification of children with high- and low-rates of CP was calculated. Predictive value of brain structure involvements and the prevalence of CP in combinations of different brain structures was also assessed. RESULTS Sixteen children (43.2%) developed CP. Relative stroke volume significantly predicted CP (p < .001). Its optimal threshold for division into high- and low-rate of CP was 3.3%. The basal ganglia (OR 8.3, 95% CI 1.2-60.0) and basis pontis (OR 18.5, 95% CI 1.8-194.8) were independently associated with CP. CONCLUSION In addition to determining the involvement of affected brain areas, the volumetric quantification of stroke volume allows accurate prediction of cerebral palsy in newborns with NAIS.

中文翻译：

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每搏量对新生儿动脉缺血性卒中运动结果的影响

背景和目的 新生儿动脉缺血性卒中 (NAIS) 可导致长期神经系统后果，例如脑瘫 (CP)。本研究的目的是通过分析脑结构受累旁边的每搏输出量来评估急性弥散加权成像 (DWI) 对 CP 的预测价值。方法 我们纳入了在全国儿科卒中登记处前瞻性登记的 37 名患有 NAIS 的足月出生婴儿。DWI 在中风表现后 0 至 8 天（平均 3 天）之间进行。参与者在 2 岁时接受神经学评估。我们计算了每搏输出量（mm3）和每搏输出量与整个大脑体积的比值（相对每搏输出量）。分析了相对每搏输出量的预测值，并计算了高低 CP 儿童分类的最佳阈值。还评估了大脑结构受累的预测价值和不同大脑结构组合中 CP 的患病率。结果 16 名儿童 (43.2%) 发生了 CP。相对每搏输出量显着预测 CP (p < .001)。其划分CP高低率的最佳阈值为3.3%。基底神经节 (OR 8.3, 95% CI 1.2-60.0) 和基础脑桥 (OR 18.5, 95% CI 1.8-194.8) 与 CP 独立相关。结论 除了确定受影响大脑区域的受累外，每搏输出量的体积量化可以准确预测患有 NAIS 的新生儿的脑瘫。还评估了大脑结构受累的预测价值和不同大脑结构组合中 CP 的患病率。结果 16 名儿童 (43.2%) 发生了 CP。相对每搏输出量显着预测 CP (p < .001)。其划分CP高低率的最佳阈值为3.3%。基底神经节 (OR 8.3, 95% CI 1.2-60.0) 和基础脑桥 (OR 18.5, 95% CI 1.8-194.8) 与 CP 独立相关。结论 除了确定受影响大脑区域的受累外，每搏输出量的体积量化可以准确预测患有 NAIS 的新生儿的脑瘫。还评估了大脑结构受累的预测价值和不同大脑结构组合中 CP 的患病率。结果 16 名儿童 (43.2%) 发生了 CP。相对每搏输出量显着预测 CP (p < .001)。其划分CP高低率的最佳阈值为3.3%。基底神经节 (OR 8.3, 95% CI 1.2-60.0) 和基础脑桥 (OR 18.5, 95% CI 1.8-194.8) 与 CP 独立相关。结论 除了确定受影响大脑区域的受累外，每搏输出量的体积量化可以准确预测患有 NAIS 的新生儿的脑瘫。相对每搏输出量显着预测 CP (p < .001)。其划分CP高低率的最佳阈值为3.3%。基底神经节 (OR 8.3, 95% CI 1.2-60.0) 和基础脑桥 (OR 18.5, 95% CI 1.8-194.8) 与 CP 独立相关。结论 除了确定受影响大脑区域的受累外，每搏输出量的体积量化可以准确预测患有 NAIS 的新生儿的脑瘫。相对每搏输出量显着预测 CP (p < .001)。其划分CP高低率的最佳阈值为3.3%。基底神经节 (OR 8.3, 95% CI 1.2-60.0) 和基础脑桥 (OR 18.5, 95% CI 1.8-194.8) 与 CP 独立相关。结论 除了确定受影响大脑区域的受累外，每搏输出量的体积量化可以准确预测患有 NAIS 的新生儿的脑瘫。