Original ArticleCerebellar Hemorrhage on Magnetic Resonance Imaging in Preterm Newborns Associated with Abnormal Neurologic Outcome
Section snippets
Methods
Preterm newborns admitted to the intensive care nursery at the University of California San Francisco (UCSF) were recruited from 1998 to 2003 as part of an ongoing prospective cohort study of brain injury and development using sequential MRI scans. Inborn and outborn neonates born at <34 weeks gestational age were eligible for the study. Exclusion criteria for study enrollment were: (1) clinical evidence of a congenital malformation or syndrome; (2) congenital TORCH infection; and (3)
Results
A cohort of 131 preterm newborns was enrolled, all of which underwent both cranial ultrasound and MRI scans during their hospital stay. Cerebellar hemorrhage was seen on cranial ultrasound in 3 newborns. All 3 of these hemorrhages were confirmed on MRI, and an additional 10 cerebellar hemorrhages that were not detected by ultrasound were seen on MRI. Three newborns died during admission in the nursery, two of whom had ultrasound-detected cerebellar hemorrhage. Of the 128 survivors, 94 underwent
Discussion
Although large cerebellar hemorrhage carries a high risk of mortality and severe neurodevelopmental deficits,8 the effects of smaller cerebellar hemorrhages seen on MRI but not on cranial ultrasound have not been reported previously. The results of the present prospective cohort study suggest that smaller cerebellar hemorrhages seen only on MRI are associated with an increased risk for abnormalities on neurologic examination, but that the presence of these hemorrhages is not associated with
References (19)
- et al.
Cerebellar hemorrhage in the premature infant
J Pediatr
(1976) - et al.
Massive intracerebellar hemorrhage in low birth weight infants
J Pediatr
(1976) - et al.
Early brain injury in premature newborns detected with magnetic resonance imaging is associated with adverse early neurodevelopmental outcome
J Pediatr
(2005) - et al.
Incidence and evolution of subependymal and intraventricular hemorhage: a study of infants with birth weight less than 1500 g
J Pediatr
(1978) - et al.
Clinical signs predict 30-month neurodevelopmental outcome after neonatal encephalopathy
Am J Obstet Gynecol
(2004) - et al.
Early prediction of neurologic outcome after perinatal depression
Pediatr Neurol
(1999) - et al.
A new pattern of cerebellar hemorrhages in preterm infants
Pediatrics
(1998) - et al.
Cerebellar injury in preterm infants: incidence and findings on US and MR images
Radiology
(2009) - et al.
Risk factors and ultrasonographic profile of posterior fossa haemorrhages in preterm infants
J Paediatr Child Health
(2009)
Cited by (110)
Use of Neuroimaging to Predict Adverse Developmental Outcomes in High-Risk Infants
2023, Principles of NeonatologyRisk Assessment and Neurodevelopmental Outcomes
2023, Avery's Diseases of the NewbornA Neurologist's Guide to Neonatal Neurodevelopmental Assessments and Preterm Brain Injury
2022, Seminars in Pediatric NeurologyCerebellar injury in premature neonates: Imaging findings and relationship with outcome
2021, Seminars in PerinatologyCerebellar injury and impaired function in a rabbit model of maternal inflammation induced neonatal brain injury
2019, Neurobiology of Learning and MemoryRedefining the Etiologic Landscape of Cerebellar Malformations
2019, American Journal of Human Genetics
Supported by the National Institutes of Health (NIH; Grant R01 NS346432, Grant UL1 RR024131, and Grant KL2 RR024130 to H.G.). E.T. is a Cerebral Palsy International Research Foundation Ethel & Jack Hausman Clinical Research Scholar. The authors declare no conflicts of interest.