Ultrasonically detectable cerebellar haemorrhage in preterm infants.
AffiliationDepartment of Neonatology, The National Maternity Hospital, Dublin, Ireland. firstname.lastname@example.org
Infant, Low Birth Weight
Infant, Premature, Diseases
Intensive Care Units, Neonatal
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CitationUltrasonically detectable cerebellar haemorrhage in preterm infants. 2011, 96 (4):F281-5 Arch. Dis. Child. Fetal Neonatal Ed.
JournalArchives of disease in childhood. Fetal and neonatal edition
AbstractTo determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).
672 infants of ≤32 weeks gestation were prospectively examined for CBH on serial cUS imaging. In a separate case--control analysis, the clinical features, ultrasound findings and outcome of preterm infants with CBH were compared to those of infants with isolated severe IVH (grade III-IV).
Nine cases of CBH were identified among 53 infants with severe IVH. The incidence of CBH in infants of ≤32 weeks gestation was 1.3%. Five infants had bilateral CBH involving both hemispheres, three had unilateral left sided CBH and one had a right hemispheric lesion. Infants with CBH were male, significantly more preterm (24.4 vs 27.0 weeks) and of lower birth weight (692 g vs 979 g). Vaginal births predominated in the CBH group (89% vs 50%). The median time to identification of haemorrhage for both groups was 3 days. Mortality in the CBH group was 100% (9/9) compared to 43% (19/44) in the severe IVH group.
Extensive CBH in preterm infants is rare and devastating. It appears to be confined to very preterm, extremely low birthweight infants and may have a male predominance. The co-existence of severe IVH and extensive CBH on routine cot-side cUS in the early neonatal period is an ominous finding.