MRI May Help Predict Perinatal Stroke Outcomes
Imaging infant brains with blocked arteries reveals signs of future neurodevelopmental problems
Perinatal arterial ischemic stroke (PAIS) is an important cause of long-lasting neurodevelopmental problems, such as cerebral palsy, cognitive deficits, language delay, epilepsy, behavioral problems and visual defects. However, most PAIS outcome studies do not differentiate between subtypes of PAIS that impact different sites of the brain.
A study published August 2 in the journal Pediatrics shows that neurodevelopmental outcomes vary among PAIS subtypes. The researchers evaluated MRI scans of 161 infants with PAIS and assessed neurodevelopmental consequences at 18 to 93 months. The newborns underwent scanning on average five days after birth. Adverse outcomes were evident in all cases after strokes affecting the main branch of the middle cerebral artery, but in only 29 percent to 57 percent of cases after other stroke subtypes. The most important outcome predictors were involvement of the corticospinal tracts and basal ganglia.
The results suggest that MRI-based risk factors can be used to predict neurodevelopmental outcomes in individual patients with perinatal stroke. According to the authors, the findings could contribute to personalized planning of therapeutic interventions and continuing support for behavioral and cognitive difficulties. However, long-term outcome studies with a prospective design are needed to determine whether early predictions in patients with PAIS remain stable over time.