RESULTS OF PARENCHYMAL AND ANGIOGRAPHIC MAGNETIC-RESONANCE-IMAGING AND NEUROPSYCHOLOGICAL TESTING OF CHILDREN AFTER STROKE AS NEONATES

We describe the long-term follow up of infants after neonatal stroke o f the middle cerebral artery (MCA). Stroke was diagnosed by CT scan in eight full-term neonates. Three dimensional (volume) magnetic resonan ce angiography (MRA) is a noninvasive technique that images the arteri al vessels without contrast agents. All patients, aged from 1.5 to 8.4 years, were investigated by MRI and MRA and by neuropsychological tes ts. Cognitive development was investigated by intelligence tests, test s of visual perception, motor and language development. Out of the eig ht patients, seven had a retarded mental and motor development, and 50 % of the children were treated for epilepsy. Seven patients had a spas tic hemi paresis. Seven out of eight children showed major cognitive d eficits. In all patients, MRI revealed clear parenchymal defects with variable distribution patterns. MRA studies showed abnormalities corre sponding to the expected vascular distribution. Children with complica tions at delivery, with seizures, and an interruption of the main stem of MCA as demonstrated on MRA had the least favourable long-term foll ow up prognosis with severe cognitive delays.