Natural History of Brain Lesions in Extremely Preterm Infants Studied With Serial Magnetic Resonance Imaging From Birth and Neurodevelopmental Assessment

Autor: Elia F. Maalouf, Joseph V. Hajnal, Joanna Allsop, Nigel Kennea, Philip Duggan, Amy H. Herlihy, Mary A. Rutherford, Leigh Dyet, Michael R. Harrison, Frances M. Cowan, Serena J. Counsell, Bridget Edwards, Morenike Ajayi-Obe, A. David Edwards, Sabrina Laroche
Rok vydání: 2006
Předmět:
Male
Pediatrics
medicine.medical_specialty
Developmental Disabilities
Leukomalacia
Periventricular
Gestational Age
Infant
Premature
Diseases
Brain damage
Neuropsychological Tests
Severity of Illness Index
Basal Ganglia
Cerebral Ventricles
Cohort Studies
White matter
Lesion
Intensive Care Units
Neonatal
London
medicine
Humans
Cerebral Hemorrhage
Fetal Growth Retardation
medicine.diagnostic_test
business.industry
Cerebral Palsy
Infant
Newborn
Brain
Infant
Gestational age
Magnetic resonance imaging
Cerebral Infarction
medicine.disease
Magnetic Resonance Imaging
Hyperintensity
medicine.anatomical_structure
Intraventricular hemorrhage
Infant
Small for Gestational Age
Pediatrics
Perinatology and Child Health
Small for gestational age
Brain Damage
Chronic
Female
Radiology
medicine.symptom
business
Infant
Premature
Dilatation
Pathologic
Follow-Up Studies
Zdroj: Pediatrics. 118:536-548
ISSN: 1098-4275
0031-4005
Popis: OBJECTIVES. The aim was to survey the range of cerebral injury and abnormalities of cerebral development in infants born between 23 and 30 weeks’ gestation using serial MRI scans of the brain from birth, and to correlate those findings with neurodevelopmental outcome after 18 months corrected age. METHODS. Between January 1997 and November 2000, consecutive infants born at RESULTS. A total of 327 MRI scans were obtained from 119 surviving infants born at 23 to 30 weeks of gestation. Four infants had major destructive brain lesions, and tissue loss was seen at term for the 2 survivors. Fifty-one infants had early hemorrhage; 50% of infants with term scans after intraventricular hemorrhage had ventricular dilation. Twenty-six infants had punctate white matter lesions on early scans; these persisted for 33% of infants assessed at term. Early scans showed cerebellar hemorrhagic lesions for 8 infants and basal ganglia abnormalities for 17. At term, 53% of infants without previous hemorrhage had ventricular dilation and 80% of infants had diffuse excessive high signal intensity within the white matter on T2-weighted scans. Complete follow-up data were available for 66% of infants. Adverse outcomes were associated with major destructive lesions, diffuse excessive high signal intensity within the white matter, cerebellar hemorrhage, and ventricular dilation after intraventricular hemorrhage but not with punctate white matter lesions, hemorrhage, or ventricular dilation without intraventricular hemorrhage. CONCLUSIONS. Diffuse white matter abnormalities and post–hemorrhagic ventricular dilation are common at term and seem to correlate with reduced developmental quotients. Early lesions, except for cerebellar hemorrhage and major destructive lesions, do not show clear relationships with outcomes.
Databáze: OpenAIRE
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