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L'infarctus cérébral artériel du nouveau-né à terme : présentation clinique, facteurs de risques et déterminants évolutifs à partir d'une cohorte prospective multicentrique d'épidémiologie descriptive

Abstract : The AVCnn study is a French multicentre cohort of 100 term newborns with symptomatic arterial ischemic stroke. The homogeneity of the population, the number of patients included, the amount of collected data and their comparison with control groups and duration of follow-up allow to make the cohort AVCnn unique in the literature. Initial data confirm that many obstetrical and perinatal factors are risk determinants (principal objective of the study). Conversely, other suspected risk factors (such as dysgravidia or mutations of coagulation factors II and V) were not confirmed, probably due to the selectivity of the inclusion criteria: previous studies have in fact included children with various types of perinatal stroke. The cause of the accident has been formally established (secondary objective) in only two cases. Nevertheless, birth weight and gender may be biomarkers of two populations of neonates with different pathological mechanisms. Prediction of motor outcomes (secondary objective) can be obtained from early imaging data (<28 days of live), while the symptoms will only appear several months later. This is of paramount importance to families and clinicians, because early intervention may help alleviate the resulting disabilities. The evaluation of quality of life and Functional Independence Measure at age 3.5 years is now complete. The developmental assessment (neuropsychological, language, and behavioural profiles, epilepsy and academic achievement) and the functional reorganization of brain MRI at 7 years have just begun
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Submitted on : Wednesday, May 16, 2012 - 10:18:38 AM
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Cyrille Renaud. L'infarctus cérébral artériel du nouveau-né à terme : présentation clinique, facteurs de risques et déterminants évolutifs à partir d'une cohorte prospective multicentrique d'épidémiologie descriptive. Médecine humaine et pathologie. Université Jean Monnet - Saint-Etienne, 2011. Français. ⟨NNT : 2011STET006T⟩. ⟨tel-00697759⟩

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