Functional Outcome at School Age of Preterm Infants With Periventricular Hemorrhagic Infarction

Abstract

The majority of surviving preterm children with periventricular hemorrhagic infarction had cerebral palsy with limited functional impairment at school age. Intelligence was within 1 SD of the norm of preterm children without lesions in 60% to 80% of the children. Verbal memory, in particular, was affected. Behavioral and executive function problems occurred slightly more than in preterm infants without lesions. The functional outcome at school age of preterm children with periventricular hemorrhagic infarction is better than previously thought.

Communication skills in individuals with spastic diplegia

“…The CP-D is characterized by the heterogeneity of motor, cognitive and behavioral manifestations, with a difficulty of forming homogeneous groups, even for those individuals who received the same classification as for the topography of the origin of the brain injury and the affected members (7,15) . With this consideration, we used the terminology, based on the GMFCS classification (25) to address the functional motor performance, as verified in the literature (2,3,19,22) , confirming the prevalence of the classification degrees of the GMFCS in CP-D, compatible to the ones found in this study. A limitation of this study was the lack of use of results of imaging tests in order to verify the presence of PVL as a sequel of neurological insult.…”

“…There is a significant correlation between intensity and motor disorders and the extension of PVL. The fibers directed to the lower limbs are located in median positions, justifying the predominance of aggravations in the lower limbs (2,15,17,19,20) . In this perspective, the neuropsychomotor development, despite the preview of alterations, offers better conditions for the acquisition of neck and trunk control, favoring the use of hands and the possibility of better manipulative and interactive skills.…”

“…The literature has presented the relation of these with brain insults, which can cause injuries compatible with CP, and also associating it to determinant factors for the development of complex language functions (5,6,11,19,22) . The Periventricular Leukomalacia (PVL) is frequent in preterms, and it can also be found among newborn at term, when the insults occur until the third gestational trimester (20) .…”

“…The severity of motor compromising, as well as the associated problems, such as: sensory, perceptive, cognitive, communication and behavior disorders, are different for each child with cerebral palsy, resulting in great variability of function in all domains (3) . Other risk factors involved in CP, among which there is prematurity, low weight, socioeconomic status and environmental opportunities (19)(20)(21)(22) . The impact of CP in communicative abilities has received attention from the literature, reflecting the importance of communication for social and educational participation, aiming at the effectiveness of intervention programs which favor the full development of these individuals (17,18,23) .…”

Chronic morbidities of premature newborns

“…stádium, amelyben az előbbi folyamatokhoz masszív intraparenchymás vérzés társul. Az újabb tanulmányok arra utalnak, hogy a koraszülöttek agya még jelentős vérzés esetében is jó funkcionális teljesítményre képes [53]. Sú-lyosabb IVH esetében, ami a III-IV.…”