Abstract
Purpose: Very low birth weight infants (VLBW) are at high risk of suffering from adverse perinatal events with possible involvement of the central nervous system and lifelong disability. Due to the growing evidence of cerebellar involvement in higher cognitive processes cerebellar lesions have become of major interest concerning motor and cognitive deficits after prematurity.
Patients: We describe a series of 29 VLBW infants (mean 972g) born between 24 and 30 gestational wks (mean GA 26,6 wks) suffering from disruption of cerebellar development as a consequence of extreme prematurity.
Methods: In order to identify risk factors for the generation of cerebellar disruptive development the perinatal course of our patients was compared to an age (mean GA 26,0 wks) and weight (mean 828g) matched control group of 29 preterm infants with normal cerebellar development, confirmed by MRI > 3rd month of life. Outcome data of motor and cognitive development of our patients were compared to a control group of 19 former premature born infants matched for gestational age, birth weight and perinatal supratentorial brain lesions.
Results: VLWB infants with cerebellar involvement suffered significantly more often from intraventricular hemorrhage (p= 0,0023), posthemorrhagic hydrocephalus (p= 0,0006) and need for neurosurgical interventions (p= 0,0002). Furthermore they exhibited more hemosiderin deposits supratentorially (p= 0,015) and infratentorially (p< 0,0001). Catecholamine support was significantly higher than in controls (p= 0,03). No other differences in perinatal risks factors were found. Despite comparable motor deficits our patients exhibited a significantly poorer cognitive performance.
Conclusion: Our data show that the immature cerebellum has a high vulnerability suggested by the different amounts of hemosiderin deposits. Disruptive cerebellar development in premature infants was associated with major supratentorial brain injuries. VLWB infants suffering from disruption of cerebellar development exhibited both motor deficits and cognitive impairment.
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Birnbacher, R., Messerschmidt, A., Fuiko, R. et al. 41 Disruption of Cerebellar Development as a Consequence of Prematurity: Perinatal Risk Factors and Neurodevelopmental Follow Up. Pediatr Res 58, 361 (2005). https://doi.org/10.1203/00006450-200508000-00070
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DOI: https://doi.org/10.1203/00006450-200508000-00070
