Posterior Fossa Abnormalities Seen on Magnetic Resonance Brain Imaging in a Cohort of Newborn Infants

Miall, Lawrence; Cornette, Luc; Tanner, Steven F.; Arthur, Rosemary; Levene, Malcolm I.

doi:10.1038/sj.jp.7210941

Cited by 46 publications

(26 citation statements)

References 20 publications

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“…The cerebellum is thought to be relatively sensitive to cerebral injury during development (14), and cerebellar injury or impairment in structural development in preterm infants has been shown to be associated with adverse neurodevelopmental outcome (11,15). Morphologic abnormality of the cerebellum has been reported as relatively common in patients with CP born extremely prematurely (16).…”

Section: Discussionmentioning

confidence: 99%

Reduction in Cerebellar Volumes in Preterm Infants: Relationship to White Matter Injury and Neurodevelopment at Two Years of Age

et al. 2006

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A substantial number of prematurely born infants will experience later neurodevelopmental challenges. Abnormal development of the cerebellum may be related to some of the impairments exhibited by preterm children. To test the hypothesis that cerebellar development is structurally impaired in preterm infants and associated with adverse outcomes, we studied 83 preterm infants and 13 term controls using volumetric magnetic resonance imaging techniques to obtain cerebellar volumes (CV) at term corrected and subsequent neurodevelopmental assessment at 2 y of age. The preterm group had smaller mean CV at term compared with the term control infants [mean (SD) CV, 22.0 (5.0) versus 23.5 (5.0) cc; mean difference (95% confidence interval), 1.5 (-1.5, 4.4)] although this did not reach statistical significance. Within the preterm group, there was evidence of a reduction in CV related to the presence of white matter injury (WMI) after adjusting for intracranial volume (ICV) [WMI grade 1 versus grade 2: mean (SD) CV, 23.6 (5.0) versus 21.6 (4.5); p ϭ 0.01; WMI grade 1 versus grade 3 and 4: 23.6 (5.0) versus 20.8 (5.6); p ϭ 0.07]. Within the preterm infants, there was no apparent relationship between CV at term and gestational age at birth after adjusting for ICV. At 2 y of age, CV showed a weak correlation with cognitive and motor development, although this was principally mediated by WMI. In conclusion, we found no evidence for a primary impairment in cerebellar development in relation to prematurity, although there was evidence for a secondary effect of cerebral WMI on cerebellar development independent of immaturity.

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Section: Discussionmentioning

confidence: 99%

Reduction in Cerebellar Volumes in Preterm Infants: Relationship to White Matter Injury and Neurodevelopment at Two Years of Age

et al. 2006

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“…Although all of these factors or a combination of these factors is plausible for the mechanism, SDH as a product of parturition has now been documented in asymptomatic neonates in multiple studies. [14][15][16][17][18][19][20][21][22][23][26][27][28] Although most of the asymptomatic SDHs seen at MR imaging and US were in neonates delivered vaginally, 18% (4 of 22) of our neonates delivered by cesarean birth also had SDH. Most infants with SDH delivered by cesarean birth (75%) had a trial of labor with oxytocin administration before the cesarean delivery.…”

Section: Discussionmentioning

confidence: 99%

“…A few published series report the finding of hemorrhages in infants who were symptomatic in the neonatal period. [14][15][16][17][18] Some reports suggest that the risk of SDH and other hemorrhages found on imaging of symptomatic infants varies with the method of delivery. 19 Sonography (US) is standard practice for detecting germinal matrix hemorrhage in the preterm neonate and has also been proved to demonstrate posterior fossa SDH.…”

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confidence: 99%

Prevalence and Evolution of Intracranial Hemorrhage in Asymptomatic Term Infants

Rooks¹,

Eaton²,

Ruess³

et al. 2008

AJNR Am J Neuroradiol

253

197

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BACKGROUND AND PURPOSE:Subdural hemorrhage (SDH) is often associated with infants experiencing nonaccidental injury (NAI). A study of the appearance and natural evolution of these birth-related hemorrhages, particularly SDH, is important in the forensic evaluation of NAI. The purpose of this study was to determine the normal incidence, size, distribution, and natural history of SDH in asymptomatic term neonates as detected by sonography (US) and MR imaging within 72 hours of birth.

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“…Associated posterior fossa abnormalities include severe reduction of cerebellar volume and a consequent enlarged fourth ventricle [3,4,5,6,7,8,9]. The clinical significance of this pathological entity, however, may remain unclear in a particular child with neurological worsening.…”

Section: Introductionmentioning

confidence: 99%

Unusual Case of ‘Trapped Fourth Ventricle’ in a Child with Posthemorrhagic Hydrocephalus – Lessons Learnt

Udayakumaran

Adani²

2011

Pediatr Neurosurg

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In most of the children with posthemorrhagic hydrocephalus (PHH), multidisciplinary follow-up is performed, with the focus on consequences of prematurity, cerebral palsy (CP) and hydrocephalus. A large fourth ventricle is common in these children but imaging performed in order to document ventricles and tissue damage is not oriented to exclude coexisting rare pathologies. We report a 3-year-old child with spastic CP, secondary to prematurity and PHH. A ventriculoperitoneal shunt was inserted at the age of 2 months. On follow-up imaging the child demonstrated well-drained supratentorial ventricles with a persistent large fourth ventricle. Because of a neurological change in spasticity and new-onset torticollis, a repeat MRI was performed, suggesting a cystic, nonenhancing lesion of the fourth ventricle. The surgical exploration revealed a large dermoid of the fourth ventricle. We analyze the differential diagnosis of a clinically significant large fourth ventricle in a shunted child with PHH and CP. This includes conditions without pressure in the posterior fossa such as tissue loss due to cerebellar atrophy, or pathologies causing a true increase in pressure of the fourth ventricle (isolated fourth ventricle, cystic lesions and neoplasms of the fourth ventricle). Neurologically compromised children pose additional challenges in reaching a definitive diagnosis and hence require a careful regular assessment of their clinical status with additional well-timed imaging with appropriate protocols to allow appropriate treatment when indicated and to avoid morbidity due to delayed diagnosis. We present a rare coexistence of a dermoid tumor within the fourth ventricle in a CP child with PHH and express the dilemmas associated with its management.

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Posterior Fossa Abnormalities Seen on Magnetic Resonance Brain Imaging in a Cohort of Newborn Infants

Abstract: Intracerebellar hemorrhage was more common in preterm infants than in term infants. These hemorrhages tended to be focal, unilateral and were associated with atrophy.

Cited by 46 publications

References 20 publications

Reduction in Cerebellar Volumes in Preterm Infants: Relationship to White Matter Injury and Neurodevelopment at Two Years of Age

Reduction in Cerebellar Volumes in Preterm Infants: Relationship to White Matter Injury and Neurodevelopment at Two Years of Age

Prevalence and Evolution of Intracranial Hemorrhage in Asymptomatic Term Infants

Unusual Case of ‘Trapped Fourth Ventricle’ in a Child with Posthemorrhagic Hydrocephalus – Lessons Learnt

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