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J Pediatr. 2011 Mar;158(3):366-71. doi: 10.1016/j.jpeds.2010.09.005. Epub 2010 Oct 20.

Differential effects of intraventricular hemorrhage and white matter injury on preterm cerebellar growth.

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  • 1Department of Neurology, University of California San Francisco, CA, USA.

Abstract

OBJECTIVE:

To hypothesize that detailed examination of early cerebellar volumes in time would distinguish differences in cerebellar growth associated with intraventricular hemorrhage (IVH) and white matter injury in preterm infants.

STUDY DESIGN:

Preterm newborns at the University of California San Francisco (n = 57) and the University of British Columbia (n = 115) were studied with serial magnetic resonance imaging scans near birth and again at near term-equivalent age. Interactive semi-automated tools were used to determine volumes of the cerebellar hemispheres.

RESULTS:

Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm(3)/week postmenstrual age (95% CI, 1.6-1.7; P < .001). More severe supratentorial IVH was associated with slower growth of cerebellar volumes (P < .001). Volumes by 40 weeks were 1.4 cm(3) lower in premature infants with grade 1 to 2 IVH and 5.4 cm(3) lower in infants with grade 3 to 4 IVH. The same magnitude of decrease was found between ipsilateral and contralateral IVH. No association was found with severity of white matter injury (P = .3).

CONCLUSIONS:

Early effects of decreased cerebellar volume associated with supratentorial IVH in either hemisphere may be a result of concurrent cerebellar injury or direct effects of subarachnoid blood on cerebellar development.

Copyright © 2011 Mosby, Inc. All rights reserved.

PMID:
20961562
[PubMed - indexed for MEDLINE]
PMCID:
PMC3025266
Free PMC Article

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