Cerebellar Injury in Preterm Infants: Incidence and Findings on US and MR Images

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

doi:10.1148/radiol.2521081525

Cited by 153 publications

(103 citation statements)

References 29 publications

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“…Cerebellar injury occurs in up to 20% of preterm infants prior to 32 weeks gestation (85). Impaired cerebellar development in preterm newborns may be caused by primarily destructive injuries or secondary lesions.…”

Section: Cerebellar Disruption or Injury Secondary To Prematuritymentioning

confidence: 99%

Congenital Abnormalities of the Posterior Fossa

Bosemani¹,

Orman²,

Boltshauser³

et al. 2015

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Section: Cerebellar Disruption or Injury Secondary To Prematuritymentioning

confidence: 99%

Congenital Abnormalities of the Posterior Fossa

Bosemani¹,

Orman²,

Boltshauser³

et al. 2015

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165

104

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“…All MR imaging examinations included a three-dimensional T1-weighted turbo fi eld-echo sequence (repetition time msec/echo time msec, 9.7/4.6; fi eld of view, 180 mm; matrix size, 192 3 152; impaired brain development and neurologic function around TEA (22)(23)(24). In addition, alterations in brain volumes and ventricular dilatation are thought to refl ect diffuse WM injury and may be associated with early adverse neurodevelopmental outcome ( 11,25,26 ).…”

Section: Image and Data Acquisitionmentioning

confidence: 99%

Clinical Implications of MR Imaging Findings in the White Matter in Very Preterm Infants: A 2-year Follow-up Study

Bruı̈ne

Berg-Huysmans²,

Leijser³

et al. 2011

Radiology

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Purpose:To explore the association between diffuse excessive high signal intensity (DEHSI), punctate white matter (WM) lesions, and ventricular dilatation around term-equivalent age (TEA) and at clinical follow-up at 2 years in very preterm infants and the effect on neurodevelopment. Materials and Methods:Ethical approval for this prospective study was given by the institutional review board, and informed parental consent was obtained. An unselected cohort of 110 preterm infants (gestational age, , 32 weeks) was imaged around or after TEA. Clinical follow-up was performed at a corrected age of 2 years and consisted of a neurologic examination and a mental and developmental assessment (Bayley Scales of Infant Development). Univariate analyses and logistic and linear regression were performed to examine the relationships between variables. Results:DEHSI was found in 58 of 65 (89%) infants imaged around TEA. DEHSI was never detected in infants imaged after postmenstrual age of 50 weeks and showed no association with neurodevelopmental outcome. Punctate WM lesions and ventricular dilatation were signifi cantly associated with mental ( P = .02 for punctate WM lesions) and psychomotor developmental delay ( P , .001 and P = .03, respectively), motor delay ( P = .002 and P = .02, respectively), and cerebral palsy ( P = .01 and P = .03, respectively). Conclusion:Because of its high incidence in preterm infants around TEA, its absence after a postmenstrual age of 50 weeks, and its association with normal neurologic outcome at a corrected age of 2 years, DEHSI should not be considered part of the spectrum of WM injury, but rather a prematurityrelated developmental phenomenon.q RSNA, 2011

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“…Previously, most research focused on the developing cerebrum and how typical supratentorial injuries like intraventricular haemorrhage (IVH) and white-matter disease (WMD) contribute to adverse outcomes. More recent advances in neuroimaging techniques have led to higher detection rates of prematurity-related infratentorial injury [3,4]. During the last trimester of gestation, coinciding with the timing of premature birth, cerebellar development undergoes an exceedingly dynamic phase characterised by the most rapid growth and an interconnection with relay brain regions unparalleled by any other cerebral structure [5].…”

Section: Introductionmentioning

confidence: 99%

The Cerebellar-Cerebral Microstructure Is Disrupted at Multiple Sites in Very Preterm Infants with Cerebellar Haemorrhage

Neubauer

Djurdjevic²,

Griesmaier³

et al. 2017

Neonatology

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Background: Recent advances in magnetic resonance imaging (MRI) techniques have prompted reconsideration of the anatomical correlates of adverse outcomes in preterm infants. The importance of the contribution made by the cerebellum is now increasingly appreciated. The effect of cerebellar haemorrhage (CBH) on the microstructure of the cerebellar-cerebral circuit is largely unexplored. Objectives: To investigate the effect of CBH on the microstructure of cerebellar-cerebral connections in preterm infants aged <32 gestational weeks. Methods: Infants underwent diffusion tensor MRI at term-equivalent age. MRI was evaluated for CBH and additional supratentorial brain injury using a validated scoring system. Region of interest-based measures of brain microstructure (fractional anisotropy [FA] and apparent diffusion coefficient) were quantified in 5 vulnerable regions (the centrum semiovale, posterior limb of the internal capsule, corpus callosum, and superior and middle cerebellar peduncles). Group differences between infants with CBH and infants without CBH were assessed. Results: There were 267 infants included in the study. Infants with CBH (isolated and combined) had significantly lower FA values in all regions investigated. Infants with isolated CBH showed lower FA in the middle and superior cerebellar peduncles and in the posterior limb of the internal capsule. Conclusions: This study provides evidence that CBH causes alterations in localised and remote WM pathways in the developing brain. The disruption of the cerebellar-cerebral microstructure at multiple sites adds further support for the concept of developmental diaschisis, which is propagated as an explanation for the consequences of early cerebellar injury on cognitive and affective domains.

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Cerebellar Injury in Preterm Infants: Incidence and Findings on US and MR Images

Cited by 153 publications

References 29 publications

Congenital Abnormalities of the Posterior Fossa

Congenital Abnormalities of the Posterior Fossa

Clinical Implications of MR Imaging Findings in the White Matter in Very Preterm Infants: A 2-year Follow-up Study

The Cerebellar-Cerebral Microstructure Is Disrupted at Multiple Sites in Very Preterm Infants with Cerebellar Haemorrhage

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