Brain imaging findings in very preterm infants throughout the neonatal period: Part I. Incidences and evolution of lesions, comparison between ultrasound and MRI

Leijser, Lara M.; Bruı̈ne, Francisca T. de; Steggerda, Sylke J.; Grond, Jeroen van der; Walther, Frans J.; Wezel‐Meijler, Gerda van

doi:10.1016/j.earlhumdev.2008.11.010

Cited by 83 publications

(65 citation statements)

References 28 publications

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“…2 Grade III-IV IVH and other lesions noted on ultrasound including periventricular leukomalacia (PVL), porencephaly, and ventriculomegaly are well documented to be associated with adverse neurodevelopmental outcomes. [3][4][5][6][7] However, the true impact of lower-grade IVH on the neurodevelopment of these extreme preterm infants has not been well described. IVH originates in the germinal matrix, which is the source of future neuronal and glial cells in the immature brain.…”

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confidence: 99%

Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

et al. 2014

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OBJECTIVE: Not many large studies have reported the true impact of lower-grade intraventricular hemorrhages in preterm infants. We studied the neurodevelopmental outcomes of extremely preterm infants in relation to the severity of intraventricular hemorrhage. METHODS: A regional cohort study of infants born at 23 to 28 weeks’ gestation and admitted to a NICU between 1998 and 2004. Primary outcome measure was moderate to severe neurosensory impairment at 2 to 3 years’ corrected age defined as developmental delay (developmental quotient >2 SD below the mean), cerebral palsy, bilateral deafness, or bilateral blindness. RESULTS: Of the 1472 survivors assessed, infants with grade III–IV intraventricular hemorrhage (IVH; n = 93) had higher rates of developmental delay (17.5%), cerebral palsy (30%), deafness (8.6%), and blindness (2.2%). Grade I–II IVH infants (n = 336) also had increased rates of neurosensory impairment (22% vs 12.1%), developmental delay (7.8% vs 3.4%), cerebral palsy (10.4% vs 6.5%), and deafness (6.0% vs 2.3%) compared with the no IVH group (n = 1043). After exclusion of 40 infants with late ultrasound findings (periventricular leukomalacia, porencephaly, ventricular enlargement), isolated grade I–II IVH (n = 296) had increased rates of moderate-severe neurosensory impairment (18.6% vs 12.1%). Isolated grade I–II IVH was also independently associated with a higher risk of neurosensory impairment (adjusted odds ratio 1.73, 95% confidence interval 1.22–2.46). CONCLUSIONS: Grade I–II IVH, even with no documented white matter injury or other late ultrasound abnormalities, is associated with adverse neurodevelopmental outcomes in extremely preterm infants.

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confidence: 99%

Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

et al. 2014

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“…This might be also true when performed earlier, although it is a current matter of discussion whether its value stands above assiduous ultrasound scans (4,31).…”

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confidence: 95%

Amplitude-Integrated EEG Pattern Predicts Further Outcome in Preterm Infants

et al. 2011

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Changes in EEG background activity are powerful but nonspecific markers of brain dysfunction. Early EEG and amplitudeintegrated EEG (aEEG) pattern predict further neurodevelopmental outcome in term infants; however, sufficient data for prognostic value of aEEG in preterm infants are not available so far. The aim of the study was to evaluate whether aEEG predicts further outcome and to compare it to cerebral ultrasound assessment. In 143 preterm infants, aEEG within the first 2 wk of life and outcome data at 3 y of age (Bayley Scales) could be obtained .aEEG was classified into a graded score according to background activity, appearance of sleep-wake cycling, and occurrence of seizure activity. In preterm infants, aEEG was significantly associated with further outcome. Specificity was 73% for assessment within the first and increased to 95% in the second week of life, whereas sensitivity stayed nearly the same 87% (first week) to 83% (second week). Cerebral ultrasound showed a specificity of 86% within the first and second week, sensitivity also stayed nearly the same (74 and 75%). aEEG has a predictive value for later outcome in preterm infants and can be used as an early prognostic tool. D espite recent advances in perinatal care, the incidence of impaired outcome in preterm infants has not decreased. Rates of CP and overt cerebral lesions [e.g. cystic leukomalacia and intraventricular hemorrhage (IVH)] are decreasing, but the incidence of neurodevelopmental impairment stays high in preterm infants. This is due to different mechanisms in brain injury (e.g. inflammation, oxidative stress, impaired connectivity) and result in mainly cognitive impairment (1-3). Extensive studies have demonstrated the usefulness of cerebral ultrasound (CUS) in detecting cerebral lesions and predicting neurological outcome (4 -7). Also conventional EEG is proven to be useful in evaluating brain function and in predicting further development (8). On the background of an acute brain insult, EEG activity shows various degrees of depression and its severity parallels the magnitude of the brain lesion. These "acute-stage" abnormalities gradually improve with time and are replaced by "chronic-stage" abnormalities such as dysmaturity and disorganization. Several studies suggest that acute changes in the EEG background are powerful but nonspecific markers of brain dysfunction (8,9). In addition, a correlation between chronic-stage abnormalities and cognitive impairment is suggested (10 -13). Although early postnatal EEG has been used increasingly in preterm infants during the last years, there is no clear evidence to confirm its prognostic value in preterm infants of Ͻ30 wk GA (9).The most dominant feature of the extremely preterm infants' EEG is discontinuity, making a "grading" and "severityscoring" in terms of depression in these infants difficult. Furthermore validated reference criteria with regard to maturation and appearance of sleep-wake cycling (SWC) to score "disorganization" and/or "dysmaturity" are still scarce.Recordi...

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“…All MRIs were assessed as recently described 30. Special attention was paid to signal intensity changes in the BGT.…”

Section: Methodsmentioning

confidence: 99%

Lenticulostriate vasculopathy in very preterm infants

Leijser

Steggerda

Bruı̈ne

et al. 2009

Archives of Disease in Childhood - Fetal and Neonatal Edition

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Brain imaging findings in very preterm infants throughout the neonatal period: Part I. Incidences and evolution of lesions, comparison between ultrasound and MRI

Cited by 83 publications

References 28 publications

Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

Intraventricular Hemorrhage and Neurodevelopmental Outcomes in Extreme Preterm Infants

Amplitude-Integrated EEG Pattern Predicts Further Outcome in Preterm Infants

Lenticulostriate vasculopathy in very preterm infants

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