The whole spectrum of cystic periventricular leukomalacia of the preterm infant: results from a large consecutive case series
| Autor: | Berndt Urlesberger, Ute Maurer-Fellbaum, Bernhard Resch, Elisabeth Pichler-Stachl, Michael Riccabona, Nora Hofer, Elisabeth Resch |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty Developmental Disabilities Leukomalacia Periventricular Gestational Age Chorioamnionitis Cerebral palsy Cohort Studies Humans Medicine Periventricular leukomalacia Respiratory distress business.industry Obstetrics Infant Newborn Infant Gestational age General Medicine Consecutive case series medicine.disease Pediatrics Perinatology and Child Health Female Neurology (clinical) Neurosurgery business Infant Premature Maternal Age Cohort study |
| Zdroj: | Child's Nervous System. 31:1527-1532 |
| ISSN: | 1433-0350 0256-7040 |
| Popis: | The purpose of this study is to describe features of cystic periventricular leukomalacia (PVL) in a large consecutive cohort study including long-term neurodevelopmental follow-up. We performed a retrospective single-centre cohort study including all preterm infants ≤35 weeks of gestational age with PVL diagnosed by ultrasound scans (US) from a tertiary care university hospital between 1988 and 2012. The majority of 160 consecutively diagnosed cases had a gestational age between 28 and 32 weeks (60.6 %), and male sex was predominant (60.6 %). The most common associated clinical findings included respiratory distress syndrome, preterm premature rupture of the membranes, and chorioamnionitis (57.5, 49.4, and 39.4 %, respectively). Infants presented with apnoeas in 66.3 and neonatal seizures in 23.1 %. Any kind of respiratory support was present in 75.0 %. Associated low-grade intraventricular haemorrhage was evident in 33.1, high-grade haemorrhage in 9.4 %. Cysts were located on both hemispheres in 75 % and PVL grades 3 and 4 were predominant (75.6 %). Neurodevelopmental follow-up of 146 cases at a median age of 72 months revealed normal development in 11.0, mental retardation in 50.0, and cerebral palsy in 83.6 %. Visual impairment was diagnosed in 21.9 % and hearing impairment in one case. A quarter of cases (27.4 %) developed seizure disorders. Outcome data were significantly better in unilateral compared to bilateral PVL. Long-term neurodevelopmental outcome of bilateral PVL always was adverse and different from unilateral PVL. The latter might be negatively influenced by associated intra- and periventricular haemorrhages. |
| Databáze: | OpenAIRE |
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