Head Circumference Is Correlated With Global Intelligence 7 Years After Neonatal Arterial Ischemic Stroke

We read with great interest the article of Leong et al ¹ demonstrating that microcephaly is associated with poor developmental outcomes in children with perinatal ischemic stroke.

We hypothesized that head circumference is correlated with developmental outcomes at 7 years of age in our cohort of term-born children with neonatal arterial ischemic stroke (AVCnn Study; NCT02511249). ² Among the 73 children of the AVCnn cohort evaluated at 7 years of age, the full-scale Intelligence Quotient (IQ) was available for 70 children. Head circumference was measured as the largest occipitofrontal circumference with a nonstretchable tape measure. Full-scale IQ was evaluated using the Wechsler Intelligence Scale for Children–Fourth Edition, as described. ² Statistical analyses were performed using GraphPad Prism version 9.1.

A strong positive correlation was observed between the head circumference and the full-scale IQ, with a Pearson correlation coefficient of 0.43 (95% confidence interval 0.21-0.60; P < .001) ( Figure 1 ). These results are in line with those found by Leong et al ¹ and confirm that head circumference is a pertinent biomarker of development in children with perinatal ischemic stroke.

Figure 1.

Head circumference and full-scale IQ at 7 years of age. (IQ, Intelligence Quotient.)

Pauline Garel, MD French Center for Pediatric Stroke, Pediatric Rehabilitation, INSERM CIC1408, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France Stéphane Chabrier, MD French Center for Pediatric Stroke, PediatricRehabilitation, INSERM CIC1408, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France INSERM U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, France Antoine Giraud, MD, PhD INSERM U1059 Sainbiose, Université Jean Monnet, Saint-Étienne, France Neonatal Intensive Care Unit, Centre Hospitalier Universitaire de Saint-Étienne, Saint-Étienne, France