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Pediatrics. 2018 Nov;142(5). pii: e20180609. doi: 10.1542/peds.2018-0609. Epub 2018 Oct 19.

Neurodevelopmental Consequences of Preterm Isolated Cerebellar Hemorrhage: A Systematic Review.

Author information

1
Department of Neonatology and.
2
Department of Pediatrics and Neonatology, St. Elisabeth Hospital, Willemstad, Curaçao.
3
Department of Neonatology, Leiden University Medical Center, Leiden, Netherlands; and.
4
Laboratory of Neuroimmunology and Developmental Origins of Disease, Wilhelmina Children's Hospital and Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
5
Department of Neuroscience, Erasmus University Medical Center, Rotterdam, Netherlands.
6
Department of Neonatology and j.dudink@umcutrecht.nl.

Abstract

CONTEXT:

The effect of neonatal cerebellar hemorrhage on neurodevelopmental outcome (NDO) in the absence of supratentorial injury is still largely unknown.

OBJECTIVE:

To evaluate the influence of isolated neonatal cerebellar hemorrhage on cognitive, motor, language, and behavioral NDOs and assess the effect of location and size on outcome.

DATA SOURCES:

Embase, Medline, and Scopus were searched from inception to September 30, 2017.

STUDY SELECTION:

Studies in which a diagnosis of isolated cerebellar hemorrhage was reported in preterm infants (<32 weeks' gestation) with a standardized NDO at ≥12 months of age were included.

DATA EXTRACTION:

Patient characteristics, location, and size of bleeding and NDO (defined as severe [yes or no] on the basis of given cutoff points) in 4 domains were extracted.

RESULTS:

Of the 1519 studies identified, 8 were included in final analyses. Of infants with isolated cerebellar hemorrhage, 128 were described (cumulative incidence: 2.3%). The incidence of severe delay in cognition, motor, language, and behavioral development was 38%, 39%, 41%, and 38%, respectively. The overall incidence of severe neurodevelopmental delay in ≥1 domain ranged from 43% to 75% and was most seen in infants with vermis involvement (87%-93%) and with large bleeds (46%-82%).

LIMITATIONS:

Different neurodevelopmental scales lead to data heterogeneity, and reporting of data on a group level limited possibilities for an outcome description on an individual level.

CONCLUSIONS:

Of infants with isolated cerebellar hemorrhage, 43% to 75% were severely delayed in cognition, motor, language, and/or behavioral development, with the highest incidence with vermis involvement and with large bleeds.

PMID:
30341153
DOI:
10.1542/peds.2018-0609
[Indexed for MEDLINE]

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