Encephalopathy of Prematurity

Back, Stephen A.; Volpe, Joseph J.

doi:10.1016/b978-0-323-42876-7.00015-6

Cited by 13 publications

(13 citation statements)

References 360 publications

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“…Infections cause a systemic inflammatory response that disrupts cerebral blood flow via cardiovascular insufficiency and secondary hypoperfusion manifesting as white matter injury. 10 Perinatal encephalitis secondary to viral infections such as human parechovirus, cytomegalovirus, enterovirus, rotavirus, influenza A and B, chikungunya, and herpes simplex virus may demonstrate extensive white matter injury, predominantly in the periventricular regions and often extending into the subcortical white matter. Deep white matter structures such as the internal capsule and the corpus callosum are commonly involved.…”

Section: Children With Stable/nonprogressive Underlying Neurological Disorder Perinatal Infectionsmentioning

confidence: 99%

Neuroradiological Mimics of Periventricular Leukomalacia

et al. 2021

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Aim: Periventricular leukomalacia (PVL) is a term reserved to describe white matter injury in the premature brain. In this review article, the authors highlight the common and rare pathologies mimicking the chronic stage of PVL and propose practical clinico-radiological criteria that would aid in diagnosis and management. Methods and Results: The authors first describe the typical brain MRI (magnetic resonance imaging) features of PVL. Based on their clinical presentation, pathologic entities and their neuroimaging findings were clustered into distinct categories. Three clinical subgroups were identified: healthy children, children with stable/nonprogressive neurological disorder, and those with progressive neurological disorder. The neuroradiological discriminators are described in each subgroup with relevant differential diagnoses. The mimics were broadly classified into normal variants, acquired, and inherited disorders. Conclusions: The term “PVL” should be used appropriately as it reflects its pathomechanism. The phrase “white matter injury of prematurity” or “brain injury of prematurity” is more specific. Discrepancies in imaging and clinical presentation must be tread with caution and warrant further investigations to exclude other possibilities.

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Section: Children With Stable/nonprogressive Underlying Neurological Disorder Perinatal Infectionsmentioning

confidence: 99%

Neuroradiological Mimics of Periventricular Leukomalacia

et al. 2021

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“…Thus, overt focal periventricular necroses are now uncommon, and WMI consists predominately of few or no focal necroses and principally a diffuse lesion in cerebral white matter [9]. The latter includes, initially, death of pre-myelinating oligodendrocytes (pre-OLs) followed by replenishment of the pre-OL pool, but a subsequent impairment of pre-OL maturation (and ultimately, hypomyelination) [3,10]. The pre-OL dysmaturation is considered to lead to (1) axonal dysmaturation, via impaired trophic interactions with pre-OLs, and (2) impaired development of cerebral cortex and thalamus, via anterograde and retrograde trans-synaptic effects caused by the axonal disturbances [3,10].…”

Section: Microglia In Cerebral White Matter Injury and Subsequent Dysmentioning

confidence: 99%

“…The latter includes, initially, death of pre-myelinating oligodendrocytes (pre-OLs) followed by replenishment of the pre-OL pool, but a subsequent impairment of pre-OL maturation (and ultimately, hypomyelination) [3,10]. The pre-OL dysmaturation is considered to lead to (1) axonal dysmaturation, via impaired trophic interactions with pre-OLs, and (2) impaired development of cerebral cortex and thalamus, via anterograde and retrograde trans-synaptic effects caused by the axonal disturbances [3,10]. The key mediators of the critical pre-OL dysmaturation is the marked gliosis that is the hallmark of the diffuse lesion.…”

Section: Microglia In Cerebral White Matter Injury and Subsequent Dysmentioning

confidence: 99%

“…The gliosis consists of "activated" microglia and reactive astrocytes. The mechanisms by which the gliosis leads to the dysmaturation of pre-OLs and neuronalaxonal structures have been discussed elsewhere [3,10,11]. The pro-inflammatory microglia are critically involved by release of reactive oxygen/nitrogen species and cytokines that then act on pre-OLs.…”

Section: Microglia In Cerebral White Matter Injury and Subsequent Dysmentioning

confidence: 99%

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Microglia: Newly discovered complexity could lead to targeted therapy for neonatal white matter injury and dysmaturation

Volpe

2019

NPM

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“…Looking at the immune system, preterm birth entails a development deficit in all its parts (innate, specific and passively acquired immunity) and that means they have a greater predisposition for the development of infections which can be vertically transmitted from mothers during pregnancy or delivery or horizontally transmitted in NICU for invasive procedures [5]. Sepsis can represent a further risk factor for the development of central nervous system injury [6,7], because the systemic inflammatory state due to infection increases the oxidative stress in cells and in particular in the white matter, where the maturation of neurons and the myelination process interrupt [8].…”

Section: Introductionmentioning

confidence: 99%

Neurodevelopmental Outcome in Very Low Birth Weight Preterm Newborns: The Role of Neonatal Sepsis

Martina¹,

Tuoni²,

Ciantelli³

et al. 2019

J Infect Dis Epidemiol

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Background: Neonatal sepsis is an independent risk factor for the development of central nervous system injury, so preterm newborn, who is more exposed to infections, has a higher neurological risk. This research wanted to examine whether and how sepsis could influence preterm newborns' neurodevelopmental outcome. Methods: We conducted an observational retrospective study with case-control design, recruiting preterm infants with gestational age ≤ 32 weeks or birth weight ≤ 1500 g. 42 patients joined the study, 21 with diagnosis of sepsis (cases: with sepsis) and 21 without infections (controls: no sepsis). We compared the two groups (no sepsis; with sepsis) means with regard to the auxological and neurodevelopmental outcomes. Results: Neuroimaging and neurodevelopmental outcome data analysis shows that the comparison between the means in the 2 groups (no sepsis; with sepsis) was statistically significant (p-value < 0.05). Conclusion: The results prove the role of sepsis in determining a greater neurocognitive impairment in this category of newborns. Anyway, this is a preliminary research which needs to be supported by further studies with a larger cross-section to confirm the hypothesis.

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Encephalopathy of Prematurity

Cited by 13 publications

References 360 publications

Neuroradiological Mimics of Periventricular Leukomalacia

Neuroradiological Mimics of Periventricular Leukomalacia

Microglia: Newly discovered complexity could lead to targeted therapy for neonatal white matter injury and dysmaturation

Neurodevelopmental Outcome in Very Low Birth Weight Preterm Newborns: The Role of Neonatal Sepsis

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