A multicenter study of neonatal stroke in Shenzhen, China
SHI Li-Xiu1, FENG Jin-Xing1, WEI Yan-Fang1, LU Xin-Ru1, ZHANG Yu-Xi1, YANG Lin-Ying1, HE Sheng-Nan2, CHEN Pei-Juan2, HAN Jing3, CHEN Cheng3, TU Hui-Ying4, YU Zhang-Bin4, HUANG Jin-Jie4, ZENG Shu-Juan5, CHEN Wan-Ling5, LIU Ying6, GUO Yan-Ping6, MAO Jiao-Yu7, LI Xiao-Dong7, ZHANG Qian-Shen8, XIE Zhi-Li8, HUANG Mei-Ying9, YAN Kun-Shan9, YING Er-Ya10, CHEN Jun10, WANG Yan-Rong11, LIU Ya-Ping11, SONG Bo12, LIU Hua-Yan12, XIAO Xiao-Dong13, TANG Hong13, WANG Yu-Na14, CAI Yin-Sha15, LONG Qi15, XU Han-Qiang16, WANG Hui-Zhan17, SUN Qian17, HAN Fang18, ZHANG Rui-Biao18, YANG Chuan-Zhong19, DOU Lei20, SHI Hui-Ju20, WANG Rui21, JIANG Ping21,Department of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen/Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong 518172, China
.Department of Neonatology, Shenzhen Children's Hospital, Shenzhen, Guangdong 518034, China (Feng J-X, Email: szfjx2013@hotmail.com) .Department of Neonatology, Shenzhen People's Hospital/Second Clinical Medical College, Jinan University/First Affiliated Hospital, Southern University of Science and Technology, Shenzhen, Guangdong 518020, China (Yu Z-B, Email: yuzhangbin@126.com) .Department of Neonatology, Longgang District Maternity & Child Healthcare Hospital of Shenzhen/Longgang Maternity and Child Institute of Shantou University Medical College, Shenzhen, Guangdong 518172, China (Chen C, Email: 2596633843@qq.com)
Abstract Objective To investigate the incidence rate, clinical characteristics, and prognosis of neonatal stroke in Shenzhen, China. Methods Led by Shenzhen Children's Hospital, the Shenzhen Neonatal Data Collaboration Network organized 21 institutions to collect 36 cases of neonatal stroke from January 2020 to December 2022. The incidence, clinical characteristics, treatment, and prognosis of neonatal stroke in Shenzhen were analyzed. Results The incidence rate of neonatal stroke in 21 hospitals from 2020 to 2022 was 1/15 137, 1/6 060, and 1/7 704, respectively. Ischemic stroke accounted for 75% (27/36); boys accounted for 64% (23/36). Among the 36 neonates, 31 (86%) had disease onset within 3 days after birth, and 19 (53%) had convulsion as the initial presentation. Cerebral MRI showed that 22 neonates (61%) had left cerebral infarction and 13 (36%) had basal ganglia infarction. Magnetic resonance angiography was performed for 12 neonates, among whom 9 (75%) had involvement of the middle cerebral artery. Electroencephalography was performed for 29 neonates, with sharp waves in 21 neonates (72%) and seizures in 10 neonates (34%). Symptomatic/supportive treatment varied across different hospitals. Neonatal Behavioral Neurological Assessment was performed for 12 neonates (33%, 12/36), with a mean score of (32±4) points. The prognosis of 27 neonates was followed up to around 12 months of age, with 44% (12/27) of the neonates having a good prognosis. Conclusions Ischemic stroke is the main type of neonatal stroke, often with convulsions as the initial presentation, involvement of the middle cerebral artery, sharp waves on electroencephalography, and a relatively low neurodevelopment score. Symptomatic/supportive treatment is the main treatment method, and some neonates tend to have a poor prognosis.
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