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.

中文翻译：

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原发围产期出血性中风后的结果轨迹。

背景技术早产和足月新生儿围产期出血性中风的研究不足。我们在前瞻性队列中描述了两个月和两年的神经系统结局。方法于2007年3月至2015年5月在三个三级儿科中心招募≥36周妊娠且患有自然出血性卒中（实质性和脑室内）≤28天的新生儿。排除了动脉缺血性中风的出血性转化或脑窦静脉血栓形成。儿科中风预后评估（PSOM）评估结果。Wilcoxon秩和检验评估了随着时间的变化。结果共纳入26例新生儿（中位年龄：1天，四分位间距[IQR] 0至16；中位胎龄：38.3周，IQR 37.0至39.0）。七分之一（27％）的脑室内出血被隔离，分离的实质内有6例（23％），组合有10例（39％）。三名新生儿（占12％）在住院期间死亡。一人死于心脏病。在22名幸存者中，评估结果的中位数为96％的2.1个月（IQR 1.7至3.3）和73％的1.9年（IQR 1.3至2.0）。PSOM中位数分别为0.0（IQR 0.0至1.0）和0.25（IQR 0.0至1.3）。在两年时，45％的患者没有或没有损害的缺陷（PSOM <1.0），30％的患者有轻度缺陷（PSOM 1.0至2.0），5％的患者有中度缺陷（PSOM 2.5至4.5）。随着时间的流逝，恶化的有31％，改善的有6％。尽管PSOM的总得分没有显着变化（P = 0.08），但语言评分却恶化了（P = 0.009）。没有儿童发生癫痫病。结论围产期出血性中风幸存者在儿童早期具有良好的预后。在两年中中度至严重的赤字发生率为5％。随着时间的流逝，可能会出现语言缺陷，因此需要密切跟进。