Evaluation of perinatal arterial ischemic stroke patients: Underlying etiologic factors and long-term prognosis.

Duman Kayar Ç., Avcı R., Kürekçi F., Öney Yılmaz C., Bayraktar Eltutan C., Abbasaliyev V., ...Daha Fazla

Brain & development, cilt.48, sa.1, ss.104501, 2026 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 48 Sayı: 1
  • Basım Tarihi: 2026
  • Doi Numarası: 10.1016/j.braindev.2026.104501
  • Dergi Adı: Brain & development
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, EMBASE, MEDLINE, Psycinfo
  • Sayfa Sayıları: ss.104501
  • Anahtar Kelimeler: Cerebral cortex, Electroencephalography, Epilepsy, Functional outcome assessment, Perinatal arterial Stroke
  • İstanbul Üniversitesi Adresli: Evet

Özet

Background: Perinatal arterial ischemic stroke (PAIS) is a major cause of long-term neurological impairments. Understanding its etiologic and prognostic factors is essential for improving outcomes. Methods: A retrospective single-center study was conducted on children diagnosed with PAIS between 2008 and 2024. Clinical, imaging, and EEG data were analyzed to identify predictors of epilepsy and poor outcomes based on modified Rankin Scale (mRS) scores. Results: A total of 44 patients (9 neonatal arterial ischemic stroke [NAIS], 35 Presumed perinatal arterial ischemic stroke [PPAIS]) with a mean follow-up of 6.49 years were included. Seizure was the first symptom in 45.5%, and focal motor deficit in 54.5%. The most affected artery was the middle cerebral artery (92%), particularly the M1 branch (36.4%). Cortical involvement was noted in 59.1%. Fourteen patients developed epilepsy; 14.2% were drug-resistant. Focal EEG slowing (odds ratio [OR] = 8.484, p = 0.019) and cortical involvement (OR = 6.857, p = 0.023) significantly predicted epilepsy. Poor mRS outcomes (≥3) were seen in 44.2%, and were associated with epilepsy (OR = 5.556, p = 0.016), EEG slowing (OR = 5.353, p = 0.035), and cortical involvement (OR = 7.467, p = 0.008). Conclusions: Early EEG and MRI findings are crucial in predicting long-term prognosis in PAIS. Further multicenter studies are needed to validate and enhance outcomes.