Independent Walking After Neonatal Arterial Ischemic Stroke and Sinovenous Thrombosis

Few studies have examined walking after neonatal arterial ischemic stroke and sinovenous thrombosis. We looked at the development of walking in a retrospective and consecutive cohort study of 88 term and near-term neonates. We used Kaplan-Meier survival curves and Cox proportional hazards models to...

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Bibliographic Details
Published in:Journal of child neurology 2003-08, Vol.18 (8), p.530-536
Main Authors: Golomb, Meredith R., deVeber, Gabrielle A., MacGregor, Daune L., Domi, Trish, Whyte, Hilary, Stephens, Derek, Dick, Paul T.
Format: Article
Language:English
Subjects:
Brain Ischemia - complications
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Gait
Humans
Infant
Male
Movement Disorders - etiology
Odds Ratio
Prognosis
Retrospective Studies
Sinus Thrombosis, Intracranial - complications
Stroke - etiology
Venous Thrombosis - complications
Walking
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Summary:Few studies have examined walking after neonatal arterial ischemic stroke and sinovenous thrombosis. We looked at the development of walking in a retrospective and consecutive cohort study of 88 term and near-term neonates. We used Kaplan-Meier survival curves and Cox proportional hazards models to assess (1) sex, (2) stroke type (arterial ischemic stroke or sinovenous thrombosis), (3) number of cerebral hemispheres with infarction, and (4) presence of neonatal comorbidity as predictors of the probability over time of starting to walk independently. These variables were assessed as predictors of parent-reported gait normality using the chi-square test on 2 × 2 contingency tables. Seventy-five of 83 survivors (90.4%, 95% confidence interval = 81.9—95.7) walked with a median time of first steps at 13 months of age (95% confidence interval = 12—14). Only bilateral strokes were associated with a lower probability over time of initiating independent walking (hazard ratio = 0.41, P = .04). Parents reported normal gait for 58 of 75 walkers (77.3%, 95% confidence interval = 67.8—86.8). No variables predicted parent-reported gait normality. Our findings suggest that most survivors of neonatal arterial ischemic stroke and sinovenous thrombosis walk with a gait that appears normal to parents, but bilateral infarctions decrease the probability over time of starting to walk independently. (J Child Neurol 2003;18:530—536).
ISSN:0883-0738
1708-8283
DOI:10.1177/08830738030180080901