The CHOPIn Study: a Multicenter Study on Cerebellar Hemorrhage and Outcome in Preterm Infants

Boswinkel, Vivian; Steggerda, Sylke J.; Fumagalli, Monica; Parodi, Alessandro; Ramenghi, Luca A.; Groenendaal, Floris; Dudink, Jeroen; Benders, Manon; Knol, Ronny; Vries, Linda S. de; Wezel‐Meijler, Gerda van

doi:10.1007/s12311-019-01053-1

Cited by 41 publications

(63 citation statements)

References 37 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Previous studies have only qualitatively described CBH size and topography. 13 Second, we primarily analyzed preterm, rather than TEA MRI. We showed that CBH volume and extent at TEA were not associated with childhood outcomes, likely due to the involution of CBH over time.…”

Section: Discussionmentioning

confidence: 99%

“…[3][4][5][6]11 These punctate CBHs are most often defined as those only visualizable on MRI and measuring <4mm in diameter on any given imaging plane. 6,[12][13][14] A recent systematic review identified 15 subjects across 8 cohort studies with isolated punctate CBH and found that 13 to 20% of them manifested severe neurodevelopmental impairment, a proportion that may not differ from the general very preterm population. 14,15 None of the included studies assessed neurodevelopment beyond 3 years of age, and therefore they may not reflect preschool-and school-age outcomes.…”

Section: Introductionmentioning

confidence: 99%

“…A recent retrospective multicenter study of neonates with CBH divided neonates into 3 qualitative CBH sizebased groups (punctate, medium-sized, and massive CBH) but did not find a consistent association between size and outcome. 13 An association between smaller CBH and neurodevelopmental outcome may nevertheless exist but be undetectable without precise, quantitative evaluation of the size and topography of the hemorrhage. Topographically, the cerebellar hemispheres are divided into the anterior and posterior lobes.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development

Garfinkle

Guo

Synnes

et al. 2020

Annals of Neurology

View full text Add to dashboard Cite

Objective: To examine the association between cerebellar hemorrhage (CBH) size and location and preschool-age neurodevelopment in very preterm neonates. Methods: Preterm magnetic resonance images of 221 very preterm neonates (median gestational age = 27.9 weeks) were manually segmented for CBH quantification and location. Neurodevelopmental assessments at chronological age 4.5 years included motor (Movement Assessment Battery for Children, 2nd Edition [MABC-2]), visuomotor integration (Beery-Buktenica Developmental Test of Visual-Motor Integration, 6th Edition), cognitive (Wechsler Primary and Preschool Scale of Intelligence, 3rd Edition), and behavioral (Child Behavior Checklist) outcomes. Multivariable linear regression models examined the association between CBH size and 4.5-year outcomes accounting for sex, gestational age, and supratentorial injury. Probabilistic maps assessed CBH location and likelihood of a lesion to predict adverse outcome. Results: Thirty-six neonates had CBH: 14 (6%) with only punctate CBH and 22 (10%) with ≥1 larger CBH. CBH occurred mostly in the inferior aspect of the posterior lobes. CBH total volume was independently associated with MABC-2 motor scores at 4.5 years (β = −0.095, 95% confidence interval = −0.184 to −0.005), with a standardized β coefficient (−0.16) that was similar to that of white matter injury volume (standardized β = −0.22). CBH size was similarly associated with visuomotor integration and externalizing behavior but not cognition. Voxelwise odds ratio and lesionsymptom maps demonstrated that CBH extending more deeply into the cerebellum predicted adverse motor, visuomotor, and behavioral outcomes. Interpretation: CBH size and location on preterm magnetic resonance imaging were associated with reduced preschool motor and visuomotor function and more externalizing behavior independent of supratentorial brain injury in a dose-dependent fashion. The volumetric quantification and localization of CBH, even when punctate, may allow opportunity to improve motor and behavioral outcomes by providing targeted intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development

Garfinkle

Guo

Synnes

et al. 2020

Annals of Neurology

View full text Add to dashboard Cite

show abstract

“…Extremely preterm infants are also prone to CBH, and after implementation of MRI for studying neonatal brain, the reported prevalence of CBH in low-birth weight infants went from 2% to a maximum of nearly 20% ( 6 , 19 , 20 ). Both lesions have a significant negative impact on neurodevelopmental outcome in preterm infants ( 21 ), although the diagnosis of minor forms of hemorrhage is often challenging with ultrasound and conventional MRI ( 4 , 22 ) and how these lesions affect neurodevelopment is still a matter of debate ( 23 , 24 ).…”

Section: Discussionmentioning

confidence: 99%

Placental Pathology Findings and the Risk of Intraventricular and Cerebellar Hemorrhage in Preterm Neonates

Parodi

Angelis

et al. 2020

Front. Neurol.

View full text Add to dashboard Cite

“…Extensive CBHs are more likely to occur in the youngest and sickest infants and are associated with the worst prognosis. 27,28 Different ultrasound features of large focal CBHs can be observed according to timing. Acute phase: a globular or less circumscript area of increased echogenicity is spotted within the cerebellar parenchyma, with possible concurrent ventricular dilatation, even in the absence of GMH-/IVH; subacute phase: less echogenic and even echolucent lesions are observed; chronic phase: focal or extensive atrophy of the cerebellum is measured.…”

Section: Acquired Lesions Of Posterior Fossamentioning

confidence: 99%

Ultrasound of acquired posterior fossa abnormalities in the newborn

et al. 2020

View full text Add to dashboard Cite

5 on behalf of the eurUS.brain group Neonatal brain sonography is part of routine clinical practice in neonatal intensive care units, but ultrasound imaging of the posterior fossa has gained increasing attention since the burden of perinatal acquired posterior fossa abnormalities and their impact on motor and cognitive neurodevelopmental outcome have been recognized. Although magnetic resonance imaging (MRI) is often superior, posterior fossa abnormalities can be suspected or detected by optimized cranial ultrasound (CUS) scans, which allow an early and bedside diagnosis and monitoring through sequential scans over a long period of time. Different ultrasound appearances and injury patterns of posterior fossa abnormalities are described according to gestational age at birth and characteristics of the pathogenetic insult. The aim of this review article is to describe options to improve posterior fossa sequential CUS image quality, including the use of supplemental acoustic windows, to show standard views and normal ultrasound anatomy of the posterior fossa, and to describe the ultrasound characteristics of acquired posterior fossa lesions in preterm and term infants with effect on long-term outcome. The limitations and pitfalls of CUS and the role of MRI are discussed.

show abstract

The CHOPIn Study: a Multicenter Study on Cerebellar Hemorrhage and Outcome in Preterm Infants

Cited by 41 publications

References 37 publications

Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development

Location and Size of Preterm Cerebellar Hemorrhage and Childhood Development

Placental Pathology Findings and the Risk of Intraventricular and Cerebellar Hemorrhage in Preterm Neonates

Ultrasound of acquired posterior fossa abnormalities in the newborn

Contact Info

Product

Resources

About