Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clínicas de Porto Alegre, Brazil

Ohlweiler, Lygia; Silva, Alexandre Rodrigues; Barros, Sonja Verginia Tamborena; Riesgo, Rudimar dos Santos; Rotta, Newra Tellechea

doi:10.1590/s0004-282x2003000600002

“…This condition is complicated by acute seizures that commonly accompany ICH in children as well as adult patients 1–3. Newborns are at particularly high risk for ICH and seizures due to traumatic deliveries, stroke, subarachnoid and intraventricular hemorrhage, and vitamin K deficiency 4–6. Studies on premature infants show a highly significant correlation between intracranial hemorrhage and seizures 4, 7.…”

mentioning

confidence: 99%

“…Newborns are at particularly high risk for ICH and seizures due to traumatic deliveries, stroke, subarachnoid and intraventricular hemorrhage, and vitamin K deficiency 4–6. Studies on premature infants show a highly significant correlation between intracranial hemorrhage and seizures 4, 7. Because seizures contribute to both mortality and morbidity, and patients with post‐ICH seizures have worse outcomes than ICH patients without seizures,2–4 understanding the cellular mechanisms responsible for the occurrence of seizures during ICH is important for developing proper medical treatment and management of ICH.…”

mentioning

confidence: 99%

Thrombin facilitates seizures through activation of persistent sodium current

Isaeva¹,

Hernan²,

Isaev³

et al. 2012

Annals of Neurology

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Objective An epileptic seizure is frequently the presenting sign of intracerebral hemorrhage (ICH) caused by stroke, head trauma, hypertension and a wide spectrum of disorders. However the cellular mechanisms responsible for occurrence of seizures during ICH have not been established. During intracerebral bleeding, blood constituents enter the neuronal tissue and produce both an acute and delayed effect on brain functioning. Among the blood components only thrombin has been shown to evoke seizures immediately after entering brain tissue. In the present study we tested the hypothesis that thrombin increase neuronal excitability in the immature brain through alteration of voltage-gated sodium channels. Methods The thrombin effect on neuronal excitability and voltage-gated sodium channels was assessed using extracellular and intracellular recording techniques in the hippocampal slice preparation of immature rats. Results We show that thrombin increased neuronal excitability in the immature hippocampus in an NMDA-independent manner. Application of thrombin did not alter transient voltage-gated sodium channels and action potential threshold. However thrombin significantly depolarized the membrane potential and produced a hyperpolarizing shift of TTX sensitive persistent voltage-gated sodium channel activation. This effect of thrombin was attenuated by application of protease-activated receptor-1 and protein kinase C antagonists. Interpretation Our data indicates that thrombin amplifies the persistent voltage-gated sodium current affecting resting membrane potential and seizure threshold at the network level. Our results provide a novel explanation as to how ICH in newborns results in seizures, which may provide avenues for therapeutic intervention in the prevention of post-ICH seizures.

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“…Um terço dessas crianças melhorou sem a necessidade de terapia anticonvulsiva 20 . Ohlweiler et al encontraram um significativo comprometimento do desenvolvimento neurológico dos recém-nascidos com a idade corrigida de 6 meses com AVC hemorrágico através da análise de tônus muscular, reflexos, força e controle da cabeça 21 .…”

Section: Avc Isquêmico Perinatalunclassified

Stroke in children

Filho¹,

Carvalho²

2009

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Objectives: To summarize 1) the definitions and epidemiological features of stroke in children; 2) the main risk factors that can lead to stroke in pediatrics and neonatology; 3) the main pathophysiological features involved in the genesis of brain injury in stroke; 4) the clinical manifestations and imaging diagnosis; and 5) the latest recommendations concerning the support measures, treatment, and prophylaxis of stroke in children.Sources: A review of the literature published in PubMed, EMBASE, and SciELO databases using the search terms stroke, pediatrics, and neonatology was performed, including relevant references from the chosen texts. Summary of the findings:Stroke in children are rare conditions, with incidence rates among two and eight per 100,000 children up to 14 years, and most cases show an underlying disease such as heart diseases, prothrombotic conditions, sickle-cell disease, and vascular malformations. There are no specific guidelines currently in place for the treatment of stroke in children, although central elements include support treatment, monitoring, and anticoagulation as secondary prevention in certain cases. Prognosis depends on the extent of brain damage and the underlying disease but recurrence rates are high in most cases. Conclusions:Early diagnosis of stroke in children is very important and pediatricians should be aware of the lack of specificity of the symptoms to avoid late sequelae and improve life quality.J Pediatr (Rio J). 2009;85(6):469-479: Stroke, pediatrics, neonatology, intensive care, anticoagulants. ResumoObjetivos: Listar 1) as definições e características epidemiológicas de acidentes vasculares encefálicos (AVE) em crianças; 2) os principais fatores de risco para a ocorrência de AVE em pediatria e neonatologia; 3) as principais características fisiopatológicas para a ocorrência de lesão cerebral no AVE; 4) as manifestações clínicas e o diagnóstico por imagem; e 5) as recomendações atualizadas para as medidas de suporte, tratamento e profilaxia dos AVE em pediatria. Fontes dos dados:Realizou-se revisão da literatura nas bases de dados PubMed, EMBASE e SciELO utilizando-se como palavras-chave stroke, pediatrics e neonatology, além da utilização de referências bibliográficas importantes dos textos escolhidos. Síntese dos dados:A ocorrência de AVE em pediatria é incomum, com a incidência variando entre duas e oito por 100.000 crianças abaixo de 14 anos, tendo a maioria como denominador comum a ocorrência de doenças de base como cardiopatias congênitas, anemia falciforme e malformações vasculares. Não há padronização nas recomendações de tratamento para o AVE em crianças, embora as medidas fundamentais incluam monitoração, tratamento de suporte e anticoagulação em casos selecionados. O prognóstico depende da extensão de área cerebral acometida e da doença de base, mas as taxas de recorrência são altas na maioria dos casos. Conclusões:O diagnóstico precoce dos AVE em pediatria é fundamental, e é importante que os pediatras estejam atentos à falta de especificidade...

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“…20 Ohlweiler et al found significant impairment in neurological development in neonates with HS analyzing muscle tone, reflexes, strength, and head control at 6 months of corrected age. 21 In newborn infants with HS, care should be taken to maintain platelets at normal levels while replacing coagulation factors and vitamin K in specific cases when necessary. Hydrocephalus is common after hemorrhagic events and must be managed using ventricular drainage if persistent or high volume.…”

Section: Perinatal Ischemic Strokementioning

confidence: 99%

Acidentes vasculares encefálicos em pediatria

Filho¹,

Carvalho²

2009

J. Pediatr. (Rio J.)

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Objectives: To summarize 1) the definitions and epidemiological features of stroke in children; 2) the main risk factors that can lead to stroke in pediatrics and neonatology; 3) the main pathophysiological features involved in the genesis of brain injury in stroke; 4) the clinical manifestations and imaging diagnosis; and 5) the latest recommendations concerning the support measures, treatment, and prophylaxis of stroke in children.Sources: A review of the literature published in PubMed, EMBASE, and SciELO databases using the search terms stroke, pediatrics, and neonatology was performed, including relevant references from the chosen texts. Summary of the findings:Stroke in children are rare conditions, with incidence rates among two and eight per 100,000 children up to 14 years, and most cases show an underlying disease such as heart diseases, prothrombotic conditions, sickle-cell disease, and vascular malformations. There are no specific guidelines currently in place for the treatment of stroke in children, although central elements include support treatment, monitoring, and anticoagulation as secondary prevention in certain cases. Prognosis depends on the extent of brain damage and the underlying disease but recurrence rates are high in most cases. Conclusions:Early diagnosis of stroke in children is very important and pediatricians should be aware of the lack of specificity of the symptoms to avoid late sequelae and improve life quality.

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Influence of intracranial hemorrhage and neonatal seizures on the neurological and psychomotor development of premature infants at Hospital de Clínicas de Porto Alegre, Brazil

Cited by 9 publications

References 12 publications

Thrombin facilitates seizures through activation of persistent sodium current

Thrombin facilitates seizures through activation of persistent sodium current

Stroke in children

Acidentes vasculares encefálicos em pediatria

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