TY - JOUR
T1 - Cerebellar Injury in Term Infants
T2 - Clinical Characteristics, Magnetic Resonance Imaging Findings, and Outcome
AU - Limperopoulos, Catherine
AU - Robertson, Richard L.
AU - Sullivan, Nancy R.
AU - Bassan, Haim
AU - du Plessis, Adré J.
N1 - Funding Information:
This work was supported by the Hearst Foundation, the LifeBridge Fund, the Caroline Levine Foundation, and the Trust Family Foundation. Catherine Limperopoulos was supported by the Canada Research Chairs Program, Canada Research Chair in Brain and Development (Tier 2).
PY - 2009/7
Y1 - 2009/7
N2 - Although cerebellar injury in the premature infant is an increasingly recognized form of neonatal brain injury, its structural and functional outcomes remain poorly defined in the term infant. The objective of this cross-sectional study was to characterize the clinical and magnetic resonance imaging features and neurodevelopmental outcome in children, born at term, with cerebellar injury. Over a 5-year period, 20 infants were identified with ischemic (n = 3) or hemorrhagic (n = 17) cerebellar injury. Lesions were small (<1 cm) in 12 cases, and large in 8 cases. Prenatal and intrapartum factors frequently documented in term infants with cerebellar injury included primiparity (55%), advanced maternal age (30%), group B streptococcus-positive mothers (35%), abnormal fetal heart rate (35%), instrumented delivery (30%), and cesarean section (25%). At follow-up of 18 cases (median age, 32 months), 39% had neurologic abnormalities. Gross motor delays, expressive language deficits, and externalizing behavioral problems were the most common (44%). Cognitive deficits were present in one third of cases. Larger cerebellar lesions were associated with significantly lower cognitive, gross motor, expressive language, and social-behavioral scores. Cerebellar injury in the term infant is associated with a broad spectrum of neurodevelopmental disabilities, particularly in infants with large cerebellar lesions.
AB - Although cerebellar injury in the premature infant is an increasingly recognized form of neonatal brain injury, its structural and functional outcomes remain poorly defined in the term infant. The objective of this cross-sectional study was to characterize the clinical and magnetic resonance imaging features and neurodevelopmental outcome in children, born at term, with cerebellar injury. Over a 5-year period, 20 infants were identified with ischemic (n = 3) or hemorrhagic (n = 17) cerebellar injury. Lesions were small (<1 cm) in 12 cases, and large in 8 cases. Prenatal and intrapartum factors frequently documented in term infants with cerebellar injury included primiparity (55%), advanced maternal age (30%), group B streptococcus-positive mothers (35%), abnormal fetal heart rate (35%), instrumented delivery (30%), and cesarean section (25%). At follow-up of 18 cases (median age, 32 months), 39% had neurologic abnormalities. Gross motor delays, expressive language deficits, and externalizing behavioral problems were the most common (44%). Cognitive deficits were present in one third of cases. Larger cerebellar lesions were associated with significantly lower cognitive, gross motor, expressive language, and social-behavioral scores. Cerebellar injury in the term infant is associated with a broad spectrum of neurodevelopmental disabilities, particularly in infants with large cerebellar lesions.
UR - http://www.scopus.com/inward/record.url?scp=66349100970&partnerID=8YFLogxK
U2 - 10.1016/j.pediatrneurol.2009.02.007
DO - 10.1016/j.pediatrneurol.2009.02.007
M3 - ???researchoutput.researchoutputtypes.contributiontojournal.article???
C2 - 19520266
AN - SCOPUS:66349100970
VL - 41
SP - 1
EP - 8
JO - Pediatric Neurology
JF - Pediatric Neurology
SN - 0887-8994
IS - 1
ER -