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Updated: Jul 29, 2026

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
Published on: August 25, 2014
[Grand prematurity, risk of neuropsychic handicaps and neuroprotection]
1Clinique de Pédiatrie et de Puériculture, Service de Médecine Néonatale, Hôpital Charles-Nicolle, Rouen.
Insights
Preterm infants face high risks of cerebral palsy and neurodevelopmental issues. New strategies focus on preventing brain lesions through infection control and neuroprotection.
Area of Science:
- Neonatal neurology
- Developmental neurobiology
- Neuroepidemiology
Context:
- While survival rates for very and extremely preterm infants have improved, they remain vulnerable to significant neurodevelopmental challenges.
- Cerebral palsy, neuromotor dysfunction, and cognitive impairments are prevalent risks in this population.
- Periventricular white matter lesions (hemorrhagic or necrotic) pose a critical threat to the developing preterm brain.
Purpose:
- To explore the multifactorial pathophysiology of brain lesions in preterm infants.
- To highlight the importance of early infection detection and management.
- To introduce novel neuroprotective strategies for preventing cerebral palsy.
Summary:
- Improved survival of preterm infants does not negate the risk of neurodevelopmental sequelae, particularly cerebral palsy.
- Brain lesions in the periventricular white matter are a primary concern for developing brains of preterm neonates.
- Advances in neuroimaging, neurobiology, and epidemiology enable a deeper understanding of brain lesion development.
Impact:
- Early detection and treatment of infections are crucial for preventing brain injury.
- Neuroprotective agents targeting excitotoxicity, free radicals, and inflammation offer promising avenues for cerebral palsy prevention.
- This research informs strategies to mitigate long-term neurological deficits in preterm survivors.
Abstract:
Increased survival of very preterm infants and extremely preterm infants does not imply an increase in neurodevelopmental sequelae. However, preterm infants remain at high risk of severe cerebral palsy with neuromotor dysfunction and mental retardation. Necrotic or hemorrhagic lesions occurring in the periventricular ring of telencephalic white matter are the most threatening events for the developing brain of these infants. Recent progress in neuroepidemiology, developmental neurobiology and imaging methods has made it possible to revisit the pathophysiology of brain lesions on a multifactorial basis. Treatment and early detection of infections is a priority. Neuroprotective agents capable of arresting neuron cell death (antagonists of the excitotoxic cascade, free-radical antagonists, proinflammatory cytokine antagonists, growth factors) are new strategies for the prevention of cerebral palsy.
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