Basal ganglia perfusion in the preterm infant during transition

Abstract

Background:The preterm brain is susceptible to changes in blood flow. Using power Doppler images, digital imaging techniques have been developed to measure the total amount of blood flow in a defined area, giving the index: fractional moving blood volume (FMBV). The aim of this study was to investigate temporal changes in basal ganglia perfusion during the transitional period after birth. Methods: Twenty-four preterm infants were examined with serial cranial ultrasounds at four time points during the first 48 h of life. FMBV was calculated using power Doppler images at each time point. results: All infants had analyzable data and FMBV was successfully calculated at all time points. Twenty-three of the 24 infants had an increasing trend in FMBV over time. The median FMBV increased from 17% at 6 h to 25% at 48 h. Oneway repeated measures ANOVA showed a significant increase in values at P < 0.001 at each of the four time points. conclusion: We have demonstrated changes in basal ganglia blood flow as the cerebral circulation adapts to extrauterine life. With further investigation, this technique may be useful in the assessment of preterm circulatory adaptation, either alone or in conjunction with other modes of evaluating cerebral blood flow.

All Wrapped Up: Environmental Effects on Myelination

“…As such, the meager blood supply to the developing cerebrum amounts to a marked susceptibility of neurovascular perfusion, and a reduced capacity to adequately respond to changes in hemodynamics [166]. Inflammation and oxidative stress also play a key role- not only in susceptibility to additional insults, like hypoxic brain injury, but also in disruption of OL developmental programs [167], and related delays in myelination [168].…”

Evaluation of neonatal cerebral perfusion using three‐dimensional power Doppler ultrasound volumes

“…Compared with our 2D studies, this study was able to calculate the FMBV value without the need for a separate reference region of interest to define 100% blood flow 21–23 . Depth differences between the interest and reference region could potentially result in different degrees of attenuation, altering the calculated FMBV value.…”