Unilateral parenchymal haemorrhagic infarction in the preterm infant

Vries, Linda S. de; Rijn, Ariadne M Roelants-van; Rademaker, Karin J; Haastert, Ingrid C. van; Beek, F. J. A.; Groenendaal, Floris

doi:10.1053/ejpn.2001.0494

Cited by 119 publications

(71 citation statements)

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“…Low cerebral blood flow in the periventricular region has indeed been shown by positron emission tomography on the side of the IPE with the area involved being more extensive than its ultrasound appearance [Volpe et al, 1983]. Following the study by Takashima et al in 1986, which showed the periventricular venous architecture using microvenography, the role of venous infarction was first suggested and this theory is now most widely accepted [Gould et al, 1987;Volpe, 1997;de Vries et al, 2001]. Venous drainage of the white matter consists of a fan-shaped leash of short and long medullary veins, through which blood flows into the veins of the germinal layer, and subsequently into the terminal veins lying inferior to the germinal layer.…”

Section: Neurodevelopmental Outcomementioning

confidence: 97%

“…When ultrasonography has been performed only once or twice, it may be difficult to make a distinction between this focal IPE and unilateral periventricular leukomalacia (PVL) and some groups therefore prefer to describe these lesions as "echolucencies" [Kuban et al, 1999]. MRI can be useful when trying to make the distinction, as both the neonatal and the MR examination in infancy show a picture which does not at all resemble PVL [de Vries et al, 2001]. Performing MR at 40 weeks postmenstrual age (PMA) has been shown to be very helpful in this type of lesion, as myelination of the posterior limb of the internal capsule (PLIC) should be present at this age.…”

Section: Neurodevelopmental Outcomementioning

confidence: 99%

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Neuroimaging in the preterm infant

Vries

Groenendaal

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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Section: Neurodevelopmental Outcomementioning

confidence: 97%

Section: Neurodevelopmental Outcomementioning

confidence: 99%

Neuroimaging in the preterm infant

Vries

Groenendaal

2002

Ment. Retard. Dev. Disabil. Res. Rev.

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“…Although cUS has been shown to be a highly reliable technique to detect PVHI (8,9), its sensitivity to detect CST involvement and its prognostic value for USCP has not been uniformly established. One study found that frontal involvement was particularly associated with abnormal neuromotor development (10), whereas other studies have shown that a large PVHI involving more than one brain region or located posterior to the trigone is associated with development of USCP (5).…”

Section: Discussionmentioning

confidence: 99%

Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction

et al. 2015

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Background:To determine the association between early neonatal diffusion tensor imaging (DTI) and the development of unilateral spastic cerebral palsy (USCP) in preterm infants with periventricular hemorrhagic infarction (PVHI). Methods: Preterm infants with PVHI were assessed with early (≤4 wk after birth) and term-equivalent age MRI-DTI. Involvement of corticospinal tracts was assessed by visual assessment of the posterior limb of the internal capsule (PLIC) on DTI (classified asymmetrical, equivocal, or symmetrical) and by an atlas-based approach calculating fractional anisotropy asymmetry index in the PLIC. Motor outcome was assessed at ≥15 mo corrected age. results: Seven out of 23 infants with PVHI developed USCP. Their PLIC was visually scored as asymmetrical in 6 and equivocal in 1 on the early DTI. Thirteen out of 16 infants with a symmetrical motor development had a symmetrical PLIC on early DTI, the remaining 3 were equivocal. All infants with USCP had a fractional anisotropy asymmetry index of >0.05 (optimal cut-off value) on early DTI. In infants with a symmetrical motor development (n = 16), 14 had an asymmetry index ≤0.05 while 2 had an index >0.05. conclusion: DTI in preterm infants with PVHI within a few weeks after birth is associated with later motor development. P eriventricular hemorrhagic infarction (PVHI) is a serioustype of brain injury that occurs in around 1-3% of preterm infants with a gestational age below 37 wk (1-3). It is a complication of a germinal matrix hemorrhage that develops due to impaired venous drainage of the medullary veins in the periventricular white matter and may have an adverse effect on corticospinal tract (CST) development (4). PVHI leads in about 50-85% of infants to, mainly unilateral, spastic cerebral palsy (USCP) (2,3,5). The diagnosis is made with cranial ultrasound (cUS) and prediction of cerebral palsy is possible in most but not all infants taken the site and size of the lesion into account (5).MRI studies performed at term-equivalent age (TEA) will reliably predict motor outcome with asymmetry in myelination of the posterior limb of the internal capsule (PLIC) due to Wallerian degeneration being almost invariably associated with the development of USCP (6).Diffusion tensor imaging (DTI) allows the study of microstructural properties of the white matter (7). To the best of our knowledge, it has not yet been studied whether early disturbances in CST integrity shortly after the onset of PVHI relate to later development of USCP. In addition, the prognostic value of DTI for early prediction of USCP in infants with PVHI is still unknown.The aim of this study was to determine the association between MRI-DTI within 4 wk after birth and the development of USCP in preterm infants with PVHI. RESULTS PatientsThe clinical characteristics and motor outcome of the study group (n = 23) are summarized in Table 1. The infants who developed cerebral palsy (n = 7, 30%) all had USCP. Cranial Ultrasound FindingsIn 16 infants with a normal motor development, the cUS on which t...

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“…2 PVI is the in utero version of germinal matrix hemorrhage, which is well described in delivered preterm infants. 3 Hemorrhage causes obstruction of medullary veins, leading to impaired drainage and venous infarction of the periventricular white matter (WM). Hemiplegic CP results when this infarct damages the corticospinal tracts.…”

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confidence: 99%

Reduced Ipsilesional Cortical Volumes in Fetal Periventricular Venous Infarction

Hodge

Wei

et al. 2012

Stroke

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Background and Purpose-Perinatal stroke causes most term-born hemiplegic cerebral palsy. Many suffer additional sequelae. Periventricular venous infarction (PVI) is a common fetal stroke in which isolated subcortical injury may cause only motor deficits. However, cognitive, language, and behavioral deficits also occur. We hypothesized that ipsilesional cortical gray matter volumes are reduced in PVI. Methods-Children (12 months to 18 years) with MRI-confirmed PVI were identified through the Alberta Perinatal Stroke Project. We developed an MRI method to quantify sectional gray (GM) and white matter (WM) volumes from lesioned and unlesioned (control) hemispheres (OsiriX software). Differences in cortical GM and WM volumes were compared between hemispheres in preselected regions "above" the lesion (middle) and anterior and posterior to this. Outcomes dichotomized for "cortical dysfunction" (cognitive, behavioral, language) and motor deficit severity (Pediatric Stroke Outcome Measure) were compared with GM volumes.

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Unilateral parenchymal haemorrhagic infarction in the preterm infant

Cited by 119 publications

References 0 publications

Neuroimaging in the preterm infant

Neuroimaging in the preterm infant

Neonatal DTI early after birth predicts motor outcome in preterm infants with periventricular hemorrhagic infarction

Reduced Ipsilesional Cortical Volumes in Fetal Periventricular Venous Infarction

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