Intracerebellar hemorrhage in premature infants: sonographic detection and outcome

Müller, Hanna; Beedgen, B.; Schenk, Jens‐Peter; Tröger, J.; Linderkamp, Otwin

doi:10.1515/jpm.2007.010

Cited by 24 publications

(17 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…These rates are comparable with those reported by other groups. [1, 16] In agreement with previous studies,[8, 9] large cerebellar hemorrhages seen on ultrasound were associated with a high risk for adverse outcome – 67% mortality was seen during the initial hospitalization. However, due to the few cases of such hemorrhage in survivors in this cohort, we were unable to assess neurodevelopmental outcome.…”

Section: Discussionsupporting

confidence: 89%

Cerebellar Hemorrhage on Magnetic Resonance Imaging in Preterm Newborns Associated with Abnormal Neurologic Outcome

Tam

Rosenbluth

Rogers

et al. 2011

The Journal of Pediatrics

122

View full text Add to dashboard Cite

Objective-To investigate the relationship between cerebellar hemorrhage in preterm infants seen on MRI but not ultrasound and neurodevelopmental outcome.Study design-MR images from a cohort study of MRI in preterm newborns were reviewed for cerebellar hemorrhage. Children were assessed at mean 4.8 years with neurological examination and developmental testing using the Wechsler Preschool and Primary Scale of Intelligence (WPPSI-III).

show abstract

Section: Discussionsupporting

confidence: 89%

Cerebellar Hemorrhage on Magnetic Resonance Imaging in Preterm Newborns Associated with Abnormal Neurologic Outcome

Tam

Rosenbluth

Rogers

et al. 2011

The Journal of Pediatrics

122

View full text Add to dashboard Cite

show abstract

“…The long-term effects of CHI are not fully understood, but there is mounting evidence to support the role of cerebellar injury in the pathogenesis of the non-motor deficits in survivors [3,8,9,21,25,58]. The largest study retrospectively compared CHI patients to age-matched controls and uncovered a significant incidence of non-motor deficits, including disorders in language and cognition as well as social and behavioral issues independent of those associated with supratentorial cerebral injury [25].…”

Section: Discussionmentioning

confidence: 99%

Cerebellar hemorrhagic injury in premature infants occurs during a vulnerable developmental period and is associated with wider neuropathology

Haines

Wang

Pierson

2013

acta neuropathol commun

View full text Add to dashboard Cite

BackgroundCerebellar hemorrhagic injury (CHI) is being recognized more frequently in premature infants. However, much of what we know about CHI neuropathology is from autopsy studies that date back to a prior era of neonatal intensive care. To update and expand our knowledge of CHI we reviewed autopsy materials and medical records of all live-born preterm infants (<37 weeks gestation) autopsied at our institution from 1999–2010 who had destructive hemorrhagic injury to cerebellar parenchyma (n = 19) and compared them to matched non-CHI controls (n = 26).ResultsCHI occurred at a mean gestational age of 25 weeks and involved the ventral aspect of the posterior lobe in almost all cases. CHI arose as a large hemorrhage or as multiple smaller hemorrhages in the emerging internal granule cell layer of the developing cortex or in the nearby white matter. Supratentorial germinal matrix hemorrhage occurred in 95% (18/19) of CHI cases compared to 54% (14/26) of control cases (p = 0.003). The cerebellar cortex frequently showed focal neuronal loss and gliosis (both 15/19, 79%) in CHI cases compared to control cases (both 1/26, 4% p < 0.0001). The cerebellar dentate had more neuronal loss (8/15, 53%) and gliosis (9/15, 60%) in CHI cases than controls (both 0/23, 0%; p < 0.0001). The inferior olivary nuclei showed significantly more neuronal loss in CHI (10/17, 59%) than in control cases (5/26, 19%) (p = 0.0077). All other gray matter sites examined showed no significant difference in the incidence of neuronal loss or gliosis between CHI and controls.ConclusionsWe favor the possibility that CHI represents a primary hemorrhage arising due to the effects of impaired autoregulation in a delicate vascular bed. The incidences of neuronal loss and gliosis in the inferior olivary and dentate nuclei, critical cerebellar input and output structures, respectively were higher in CHI compared to control cases and may represent a transsynpatic degenerative process. CHI occurs during a critical developmental period and may render the cerebellum vulnerable to additional deficits if cerebellar growth and neuronal connectivity are not established as expected. Therefore, CHI has the potential to significantly impact neurodevelopmental outcome in survivors.

show abstract

“…The incidence of cerebellar haemorrhage in our study period (0.5%) was much lower than in previous studies [1, 4, 10, 15, 17]. A possible explanation for this could be that we included infants less than 37 weeks gestation instead of only very low birth weight infants.…”

Section: Discussionmentioning

confidence: 53%

“…Cerebellar haemorrhage in preterm infants has become a focus of attention, as it is associated with neurodevelopmental sequelae and mortality [1, 11, 15, 17]. Prevalences ranging from 2.3% to 19% for very low birth weight infants (VLBW) have been reported [10, 15, 17, 21].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

The clinical presentation of preterm cerebellar haemorrhage

et al. 2010

View full text Add to dashboard Cite

The objective of this study was to evaluate clinical symptoms and findings on cranial ultrasound (CUS) in preterm infants with cerebellar haemorrhage through retrospective analysis of all preterm infants with a postnatal CUS or MRI diagnosis of cerebellar haemorrhage admitted in a tertiary care centre between January 2002 and June 2009. Fifteen infants were identified; median gestational age was 25 2/7 weeks and median birth weight 730 g. We discerned six types of haemorrhage: subarachnoid (n = 3), folial (n = 1), lobar (n = 9, of which 4 bilateral), giant lobar (n = 1, including vermis) and contusional (n = 1). Especially in infants with lobar cerebellar haemorrhage, CUS showed preceding or concurrent lateral ventricle dilatation, mostly without intraventricular haemorrhage (IVH). Thirteen infants suffered from notable, otherwise unexplained motor agitation in the days preceding the diagnosis. In conclusion, motor agitation may be a presenting symptom of cerebellar haemorrhage in preterm infants. Unexplained ventriculomegaly can be a first sign of cerebellar haemorrhage and should instigate sonographic exploration of the cerebellum.

show abstract

Intracerebellar hemorrhage in premature infants: sonographic detection and outcome

Abstract: Cerebellar hemorrhage is not rare if ultrasound examination is specifically focused on cerebellar lesions.

Cited by 24 publications

References 11 publications

Cerebellar Hemorrhage on Magnetic Resonance Imaging in Preterm Newborns Associated with Abnormal Neurologic Outcome

Cerebellar Hemorrhage on Magnetic Resonance Imaging in Preterm Newborns Associated with Abnormal Neurologic Outcome

Cerebellar hemorrhagic injury in premature infants occurs during a vulnerable developmental period and is associated with wider neuropathology

The clinical presentation of preterm cerebellar haemorrhage

Contact Info

Product

Resources

About