ABSTRACT. Background. Intraventricular hemorrhage (IVH) is the most common brain injury among premature infants. Neonates with IVH are at greater risk of impaired neurodevelopmental outcomes, compared with those without IVH. IVH causes destruction of the germinal matrix and glial precursor cells, with possible effects on cortical development.Objective. To investigate cortical development after uncomplicated IVH (with no parenchymal involvement and no posthemorrhagic hydrocephalus). We hypothesized that uncomplicated IVH would be followed by reduced cortical volume among premature infants at near-term age.Methods. A prospective cohort study was conducted, with preset selection criteria. Infants with small-for-gestational age birth weight, congenital abnormalities or brain malformations, metabolic disorders, recurrent sepsis, or necrotizing enterocolitis were excluded. Also, infants with posthemorrhagic hydrocephalus, parenchymal involvement of hemorrhage, cystic periventricular leukomalacia, or persistent ventriculomegaly were excluded, on the basis of routine serial ultrasonographic assessments. Three-dimensional images were acquired for 23 infants at near-term age, with 3-T magnetic resonance imaging and a magnetization-prepared rapid gradient echo sequence. Image analysis and segmentation of the cerebrum in different tissue types were based on signal contrast and anatomic localization. The cortical gray matter (CGM), subcortical gray matter, white matter, and intraventricular cerebrospinal fluid volumes of 12 infants with uncomplicated IVH were compared with those of 11 infants without IVH, using multivariate analysis of variance.Results. The multivariate analysis of variance for the regional brain volumes in the 2 groups indicated significance (Wilks' ‫؍‬ 0.546). The CGM volume was significantly reduced in the IVH group (no-IVH group: 122 ؎ 12.9 mL; IVH group: 102 ؎ 14.6 mL; F ‫؍‬ 13.218). This finding remained significant after testing for possible confounding factors and adjustment for size differences between the infants (F ‫؍‬ 9.415). There was no difference in the volumes of subcortical gray matter, white matter, and cerebrospinal fluid.Conclusions. This is the first study to document impaired cortical development after uncomplicated IVH. ABBREVIATIONS. IVH, intraventricular hemorrhage; CSF, cerebrospinal fluid; CGM, cortical gray matter; SGM, subcortical gray matter; WM, white matter; MRI, magnetic resonance imaging; CI, confidence interval. I ntraventricular hemorrhage (IVH) is the most common brain injury among premature infants and is the most common type of neonatal intracranial hemorrhage. 1,2 The incidence is directly correlated with the degree of prematurity. As the survival rates for premature infants continue to increase, IVH will continue to be a major problem in modern neonatal intensive care units. 1,2 It is known that IVH with associated ventriculomegaly or parenchymal involvement is associated with neurodevelopmental handicaps and disabilities. 3-5 Furthermore, studies have indicated that ...

Our study showed that IOP was significantly lower in women taking HT than in those who had never taken HT, even after removing other possible influences on IOP. The IOP-lowering effect of HT deserves further investigation to explore whether it may represent a possible new therapeutic modality for glaucoma.

ABSTRACT:The pattern of sexual differentiation of the human brain is not well understood, particularly at the early stages of development when intense growth and multiple maturational phenomena overlap and interrelate. A case-control study of 20 preterm males and females matched for age was conducted. Threedimensional images were acquired with 3 T MRI. The cerebral volume and the cortical folding area (FA), defined as the surface area of the interface between cortical gray and white matter, were compared between males and females. Females had smaller cerebra than males even after removing the influence of overall size differences between the subjects. The cortical FA increased in relation to volume by a power of 4/3 in both groups. Females had larger cortical FA compared with males with similar cerebral volumes. The study provides in vivo evidence of sexually dimorphic early human brain development. The relatively more "compact" female model may well relate to sex differences in neural circuitry and cognitive domains. O ver the last decades, there is emerging evidence of early sexual dimorphism of the brain. Studies in animals have shown that fetal testes secrete testosterone independently of gonadotrophins and the male brain is exposed to high levels of these hormones (1,2). Aromatase, the enzyme converting testosterone to estradiol, plays a crucial role in sexually dimorphic prenatal brain development (3-5), and there are malefemale differences in estrogen receptors during fetal development (6 -8). Furthermore, genetic studies have reported that the genes associated with sex chromosomes directly affect brain sexual differentiation, suggesting that genetic influence on early brain development precedes or overlaps with the epigenetic action of gonadal hormones (9 -12). In humans, MRI can be used to in vivo investigate early morphologic and structural differences between males and females in the developing brain.Based on the literature, it is evident that hormonal effects and genetic mechanisms influence sex-related brain developmental phenomena. However, the pattern of early sexual differentiation of the human brain has not been explored and is not fully understood. It is not clear whether and how sex-related differences in early brain development are related to growth and maturational phenomena such as somatic growth, cerebral growth, and cortical folding.This study aimed to investigate the pattern of cerebral growth and cortical folding in infants at a preterm stage of development, comparing the findings between males and females. To remove the influence of age, a significant determinant factor of early brain development (13,14), a casecontrolled study was conducted, matching the infants in the two groups for age. METHODSStudy design and participants. Written informed consent was given by the parents and ethics approval was received from the University of Western Ontario Health Sciences Research Ethics Board. Preterm infants with weight appropriate for gestational age (AGA) below 1.5 kg were included in the st...

Neonatal herpes simplex virus (HSV) infection is usually acquired at birth. We present an infant with intrauterine HSV infection acquired after rupture of membranes. The infant was born prematurely to a woman with a first episode of genital herpetic infection in early pregnancy and rupture of membranes 11 days prior to delivery. The infant, at delivery had extensive brain damage, hemorrhage, and cystic encephalomalacia due to herpes infection. On 2nd day of life, Magnetic Resonance Imaging, suggested that the hemorrhage had occurred 7 to 14 days before the scan and the placental pathology was supportive of an ascending infection. The case of an ascending herpetic intrauterine infection after rupture of the membranes raises the question of prevention and suppressive antiviral therapy.