Neurological assessment of the preterm infant

Vries, LS de

doi:10.1111/j.1651-2227.1996.tb14149.x

Cited by 48 publications

(50 citation statements)

References 82 publications

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“…Resultados normais da USC ou a presença de HPV de grau I ou II foram associados a um prognóstico neurológico satisfatório, embora alguns desses recém-nascidos tenham apresentados anormalidades neurológi-cas no seguimento 3,8,10,30 . Esses achados são concordantes com nossos resultados.…”

Section: Discussionunclassified

“…The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants Juliana M. Garcia 1 , José Luiz D. Gherpelli 2 , Cléa R. Leone 3 A ultra-sonografia de crânio (USC) é o procedimento mais indicado para o diagnóstico da lesão cerebral precoce no período neonatal. Vários achados sonográficos têm sido relacionados com a evolução neurológica 3 .…”

Section: Importância Da Avaliação Dos Movimentos Generalizados Espontunclassified

“…Vários achados sonográficos têm sido relacionados com a evolução neurológica 3 . Mortalidade e seqüelas neurológicas estão diretamente relacionadas a lesões na substância branca periventricular, observadas no recém-nascido pré-termo com patologias neonatais 4 .…”

Section: Importância Da Avaliação Dos Movimentos Generalizados Espontunclassified

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The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants

Garcia¹,

Gherpelli²,

Leone³

2004

J Pediatr (Rio J)

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IntroduçãoApesar dos avanços na assistência pré-natal e na terapia intensiva neonatal terem gerado uma redução significante na mortalidade neonatal, os recém-nascidos pré-termo (RNPT) ainda correm risco de disfunções do sistema nervoso relacionadas a lesões cerebrais ocorridas durante os períodos pré-natal e perinatal 1 .Os principais distúrbios neurológicos comumente relacionados à lesão cerebral perinatal no RNPT incluem as formas diplégica e hemiplégica de paralisia cerebral, geralmente acompanhadas de distúrbios cognitivos. As neuropatologias usualmente relacionadas a esses distúr-bios motores são o infarto hemorrágico periventricular considerado uma das complicações da hemorragia periventricular e a leucomalácia periventricuar 2 . ARTIGO ORIGINAL AbstractObjective: To study the relationship among the quality, type, and trajectory of general movements in preterm infants and neonatal cranial ultrasonography findings and neurological outcome.Method: Forty preterm newborn infants, with gestational ages under 35 weeks, had their general movements recorded through video-tape during the preterm, term (37th -42nd postconceptional weeks of age) and post-term (49th 56th postconceptional weeks of age) periods, and were prospectively followed up to one-year conceptional age.Results: Our results showed that the quality of general movements, particularly in the post-term period (p = 0.009), were related with the presence of severe cerebral lesions in the neonatal cranial ultrasonography and the neurological outcome. While the presence of severe ultrasonography lesions was associated with an adverse neurological outcome (p = 0.01), the finding of normal general movements patterns was associated with a normal neurological outcome, with negative predictive values of 100%, for the preterm, and 80%, for both term and post-term periods.Conclusions: When concurrently used, these evaluation methods may increase the specificity and sensitivity in detecting the group of preterm infants at high risk for neurological disturbances in longterm follow-up.J Pediatr (Rio J). 2004;80(4):296-304: Low birth weight infant, intracranial hemorrhages, periventricular leukomalacia, motor activity, neurologic examination, ultrasonography, prognosis. ResumoObjetivo: Estudar a relação entre a qualidade, tipos e trajetória dos movimentos generalizados espontâneos em recém-nascidos pré-termo com os achados da ultra-sonografia de crânio neonatal e com a evolução neurológica.Método: 40 recém-nascidos pré-termo, com idades gestacionais < 35 semanas, tiveram seus movimentos generalizados registrados através de videoteipe durante os períodos pré-termo, a termo (37 a -42 a semana de idade pós-concepcional) e pós-termo (49 a -56 a semana de idade pós-concepcional), e foram seguidos prospectivamente até um ano de idade pós-concepcional.Resultados: Nossos resultados mostraram que a qualidade dos movimentos generalizados, particularmente no período pós-termo (p = 0,009), foram relacionados com a presença de lesões cerebrais detectadas à ultra-sonografia e com ...

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Section: Discussionunclassified

Section: Importância Da Avaliação Dos Movimentos Generalizados Espontunclassified

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The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants

Garcia¹,

Gherpelli²,

Leone³

2004

J Pediatr (Rio J)

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“…These figures are in close agreement with the findings of Whyte (1993) who found a negative predictive value of 88.9% with respect to the flash VEP and abnormal neurological outcome in term infants with perinatal asphyxia. In addition to flash VEPs, the prognosis of preterm infants can be established using clinical assessment, neuroimaging, encephalography, and other modalities of evoked potentials (de Vries 1996). In particular, somatosensory evoked potentials (SEP) and brainstem auditory evoked potentials (BAEP) have been used in the preterm nursery.…”

Section: Discussionmentioning

confidence: 99%

Prognostic value of flash visual evoked potentials in preterm infants

Shepherd

Saunders²,

McCulloch

et al. 1999

Develop Med Child Neuro

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This paper investigates the prognostic value of flash visual evoked potentials (VEPs) recorded in preterm infants at birth and at term age with respect to severe neurological outcome. Flash VEPs were recorded in 81 preterm infants at birth (i.e. <35 weeks' gestation) and repeated in 56 of these infants at term age. The preterm infants were assigned to either a healthy or at-risk subgroup based on clinical birth factors. Normal ranges of flash-VEP latencies, amplitudes, and number of components present were obtained from the subgroup of healthy preterm infants and from 68 term infants tested postnatally. The flash-VEP results of the entire preterm group were compared with the normal ranges and any abnormalities noted. Seven preterm infants in the at-risk group died, six of whom had abnormal flash VEPs before term age. Of the five infants from the at-risk group diagnosed with cerebral palsy (CP), three had abnormal flash VEPs before term age. Thus the sensitivity and specificity of the flash VEP with respect to survival was 86% and 89% respectively, and with respect to the development of CP was 60% and 92%. The abnormal features of the flash VEP associated with adverse outcomes comprised a delayed N3 component before term age and the absence of a positive component (P2) at term age.

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“…Cranial ultrasound (cUS) is the preferred and most readily available tool to assess the neonatal brain [1]. It is a safe and reliable technique for demonstrating the most frequently occurring forms of cerebral injury in preterm infants,In preterm infants, increased echogenicity in the periventricular white matter (WM), so-called periventricular flaring, may represent ischemic and/or inflammatory damage.…”

Section: Introductionmentioning

confidence: 99%

Comparing brain white matter on sequential cranial ultrasound and MRI in very preterm infants

et al. 2008

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Introduction Periventricular white matter (WM) echodensities, frequently seen in preterm infants, can be associated with suboptimal neurodevelopment. Major WM injury is well detected on cranial ultrasound (cUS). cUS seems less sensitive for diffuse or more subtle WM injury. Our aim was to assess the value of cUS and magnetic resonance imaging (MRI) for evaluating WM changes and the predictive value of cUS and/or MRI findings for neurodevelopmental outcome in very preterm infants with normal to severely abnormal WM on sequential high-quality cUS. Materials and methods Very preterm infants (<32 weeks) who had sequential cUS and one MRI within the first three postnatal months were included. Periventricular WM on cUS and MRI was compared and correlated with neurodevelopmental outcome at 2 years corrected age. Results Forty preterm infants were studied; outcome data were available in 32. WM changes on sequential cUS were predictive of WM changes on MRI. Severely abnormal WM on cUS/MRI was predictive of adverse outcome, and normal-mildly abnormal WM of favorable outcome. Moderately abnormal WM on cUS/MRI was associated with variable outcome. Additional MRI slightly increased the predictive value of cUS in severe WM changes.

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Neurological assessment of the preterm infant

Cited by 48 publications

References 82 publications

The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants

The role of spontaneous general movement assessment in the neurological outcome of cerebral lesions in preterm infants

Prognostic value of flash visual evoked potentials in preterm infants

Comparing brain white matter on sequential cranial ultrasound and MRI in very preterm infants

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