Intracranial Hemorrhage

AimTo determine whether isolated low‐grade germinal matrix‐intraventricular haemorrhages (LG‐GMH‐IVH) and low‐grade punctate cerebellar haemorrhages (LG‐CBH) contribute to the neurodevelopment of infants born preterm with very low birthweight (VLBW).MethodA prospective observational cohort study was conducted on infants born with VLBW hospitalized from January 2012 to July 2017 who had undergone serial cranial ultrasounds since birth and magnetic resonance susceptibility‐weighted imaging of the brain at term‐corrected age. Only those with VLBW carrying isolated LG‐GMH‐IVH (grades 1 or 2) or isolated LG‐CBH (punctate cerebellar haemorrhages ≤4 mm in diameter) or absence of lesions (no‐lesion) were enrolled and followed up to 3 years. The Griffiths Mental Development Scales, Extended and Revised version (GMDS‐ER), were used to assess neurodevelopment, considering unsatisfactory scores less than 85. Behaviour, according to the criteria of the International Classification of Diseases, 10th Revision, and rehabilitation data were noted.ResultsTwo‐hundred and forty infants with VLBW were enrolled: 34 with LG‐GMH‐IVH, 17 with LG‐CBH, and 189 as no‐lesion. The LG‐GMH‐IVH and LG‐CBH groups scored worse than the no‐lesion group on all GMDS‐ER scores for 1 year, 2 years, and 3 years. The LG‐CBH group scored lower than the LG‐GMH‐IVH group for total GMDS‐ER scores at 1 year and 2 years but not at 3 years. At 3 years, compared with the LG‐CBH group, those with LG‐GMH‐IVH received less and later physical therapy, with more frequent attention problems. The odds ratio for unsatisfactory GMDS‐ER scores corrected for gestational age was 5.75 for LG‐CBH (95% confidence interval 1.92–17.25; p = 0.002) and 2.67 for LG‐GMH‐IVH (95% confidence interval 1.16–6.13; p = 0.02).InterpretationLow‐grade haemorrhages affect the neurodevelopment of very‐low‐birthweight infants. Early rehabilitation might have contributed to their development.

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“…GMH‐IVH was classified according to Inder et al, 19 while CBH was classified according to previous literature 6,10 …”

Section: Methodsmentioning

confidence: 99%

“…GMH-IVH was classified according to Inder et al, 19 while CBH was classified according to previous literature. 6,10 MRI studies including SWI sequence were performed on a 1.5T scanner (InteraAchieva 2.6; Philips, Best, the Netherlands) using a dedicated neonatal head array coil.…”

Section: Imaging Datamentioning

confidence: 99%

Influence of isolated low‐grade intracranial haemorrhages on the neurodevelopmental outcome of infants born very low birthweight

Uccella

Parodi

Calevo

et al. 2023

Develop Med Child Neuro

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“…Our patient's MRI brain showed a small convexal subdural hemorrhage in the left precentral sulcus (Figure 2 ). This type of subdural hemorrhage is common with a prevalence of 8%-25 % and is not associated with neurodevelopmental impairment [ 6 ]. Therefore, we believe that the fetal distress and subdural hemorrhage were not contributing factors to the severe hypotonia, severe developmental delay, and developmental association that were observed in our patient.…”

Section: Discussionmentioning

confidence: 99%

“…Brain magnetic resonance was performed on day six of life, which was reported as normal, except for a small convexal subdural hemorrhage in the left precentral sulcus (Figure 2 ). As all her basic investigations were unremarkable, and this type of subdural hemorrhage is common and benign [ 6 ], a whole exome sequencing (WES) analysis was conducted when she was 22 days old at PerkinElmer Genomics. Two variants were identified: a nonsense variant c.966G>A (p.Trp322Ter) in CHD1 and a missense variant c.1723T>G ( p.Se r575Ala) in ASH1L (absent small and homeotic disks protein 1 homolog like histone lysine methyltransferase).…”

Section: Case Presentationmentioning

confidence: 99%

A Saudi Girl With Co-occurring CHD1 (Pilarowski-Bjornsson Syndrome) and ASH1L Gene Variants

Al-Aamri,

Alshaqaq,

Al-Abdi

2023

Cureus

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Pilarowski-Bjornsson Syndrome (PBS) is a recently identified and rare genetic disorder. PBS is caused by missense variants in the CHD1 gene, a chromatin remodeler and helicase DNA-binding protein. In this report, we present the first case of PBS in Saudi Arabia. The patient exhibits a phenotype and genotype that are consistent with previously reported cases of PBS. Notably, this case is unique due to the coexisting presence of an absent, small, and homeotic disks protein 1 homolog like a histone lysine methyltransferase (ASH1L) variant and developmental dissociation. The ASH1L variant may contribute to the developmental dissociation observed in the patient. Furthermore, since the patient is female, this case contributes to the female-skewed distribution of PBS, although the exact cause of this phenomenon requires further investigation. This report highlights the importance of identifying and characterizing rare genetic disorders such as PBS. Understanding the genetic basis of these disorders can lead to improved diagnosis, treatment, and management strategies. Continued research on the genetic and molecular mechanisms underlying PBS and related disorders is crucial for advancing our knowledge and developing effective therapies.

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“…An intracranial hemorrhage (ICH) in the neonatal period is a serious clinical problem and an important cause of morbidity and mortality [ 52 ]. Many inherited and acquired disorders may cause a neonatal ICH.…”

Section: Clinical Applicationsmentioning

confidence: 99%

The Use of Contrast-Enhanced Ultrasound (CEUS) in the Evaluation of the Neonatal Brain

Plut,

Prutki,

Slak

2023

Children

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In recent years, advancements in technology have allowed the use of contrast-enhanced ultrasounds (CEUS) with high-frequency transducers, which in turn, led to new possibilities in diagnosing a variety of diseases and conditions in the field of radiology, including neonatal brain imaging. CEUSs overcome some of the limitations of conventional ultrasounds (US) and Doppler USs. It allows the visualization of dynamic perfusion even in the smallest vessels in the whole brain and allows the quantitative analysis of perfusion parameters. An increasing number of articles are published on the topic of the use of CEUSs on children each year. In the area of brain imaging, the CEUS has already proven to be useful in cases with clinical indications, such as hypoxic-ischemic injuries, stroke, intracranial hemorrhages, vascular anomalies, brain tumors, and infections. We present and discuss the basic principles of the CEUS and its safety considerations, the examination protocol for imaging the neonatal brain, and current and emerging clinical applications.

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Intracranial Hemorrhage

Cited by 16 publications

References 266 publications

Influence of isolated low‐grade intracranial haemorrhages on the neurodevelopmental outcome of infants born very low birthweight

Influence of isolated low‐grade intracranial haemorrhages on the neurodevelopmental outcome of infants born very low birthweight

A Saudi Girl With Co-occurring CHD1 (Pilarowski-Bjornsson Syndrome) and ASH1L Gene Variants

The Use of Contrast-Enhanced Ultrasound (CEUS) in the Evaluation of the Neonatal Brain

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