Article

The aim of the study was to compare clinical and neuroimaging
characteristics and neurodevelopmental outcome in preterm infants with a
periventricular haemorrhagic infarction (PVHI) located in the temporal or frontal
periventricular white matter. METHOD: The study was a retrospective
hospital-based study of preterm infants with a frontal PVHI (n=21; 11 males, 10
females; mean birthweight 1527g; mean gestational age 30.3wks) or temporal PVHI
(n=13; five males, eight females; mean birthweight 1205g; mean gestational age
30.2wks) admitted to the neonatal intensive care unit between 1990 and 2012. The
clinical course, results of neuroimaging studies, and neurodevelopmental outcomes
of preterm infants with a gestational age less than 34 weeks with a confirmed
PVHI on early cranial ultrasonography and/or magnetic resonance imaging were
reviewed. For assessment of neurodevelopmental outcome we used the Griffiths
Mental Development Scales, the Movement Assessment Battery for Children, the
Gross Motor Function Classification System, the Wechsler Preschool and Primary
Scale of Intelligence, the Child Behavior Checklist, and ophthalmological
assessment. An unfavourable neurodevelopmental outcome was defined as moderately
or severely atypical neurological examination during the last visit: presence of
cerebral palsy, epilepsy, a hearing or visual impairment, and/or atypical
cognitive development (Griffiths Mental Development Scales developmental quotient
or Wechsler Preschool and Primary Scale of Intelligence <85). RESULTS:
Unfavourable outcome was observed in 12 out of 13 children with a temporal PVHI
compared with six out of 21 children with a frontal PVHI (p=0.002). Only one of
the included infants with a PVHI in the temporal white matter developed cerebral
palsy, which was due to a parietal PVHI in the contralateral hemisphere.
Cognitive impairment was noted in seven infants with a frontal PVHI and five with
a temporal PVHI. There were more infants with a temporal PVHI who developed
visual impairment (n=5) or behavioural problems (n=7) compared with those with a
frontal PVHI (visual impairment (n=2), behavioural problems (n=3).
INTERPRETATION: PVHI located in the temporal or frontal lobe is almost invariably
related to a typical motor outcome, but carries a risk of cognitive, behavioural,
and visual problems, especially in infants with a PVHI located in the temporal
lobe.
CI - (c) 2014 Mac Keith Press.

Langue : ANGLAIS