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Published on: November 20, 2015
Long-term outcome after neonatal intraparenchymal echodensities with porencephaly
R L Sherlock1, A R Synnes, R E Grunau
1Department of Neonatology, Children's and Women's Health Center of British Columbia, 4480 Oak St, Vancouver, British Columbia V4H3V4, Canada. rsherlock@cw.bc.ca
Insights
Neonatal intraparenchymal echodensities (IPE) with porencephaly are linked to significantly worse long-term neurodevelopmental outcomes. These infants face higher rates of motor, cognitive, and social impairments throughout childhood.
Area of Science:
- Neonatal neurology
- Pediatric neurodevelopment
- Medical imaging in neonates
Background:
- Neonatal intensive care unit (NICU) survivors with specific brain abnormalities face unique challenges.
- Intraparenchymal echodensities (IPE) with porencephaly are serious findings on cranial ultrasonography.
- Understanding long-term outcomes is crucial for early intervention and support.
Purpose of the Study:
- To compare long-term neurodevelopmental and functional outcomes of NICU survivors with neonatal IPE and porencephaly against matched controls.
- To analyze the developmental trajectories of these infants from infancy through adolescence.
Main Methods:
- A cohort study design was employed.
- Cases were NICU survivors (birth weight <1250 g) with grade 4 intraventricular hemorrhage (IVH) and confirmed IPE with porencephaly via cranial ultrasonography.
- Matched controls with normal cranial ultrasound findings were selected. Assessments occurred up to 17 years.
Main Results:
- 10 infants with IPE and porencephaly survived to discharge.
- All cases exhibited significant impairments compared to controls (p<0.001).
- Motor, cognitive, and overall impairment rates were consistently higher in cases (p≤0.002).
Conclusions:
- Neonatal IPE with porencephaly is associated with substantially worse long-term neurodevelopmental outcomes.
- Affected children often require learning assistance and face social challenges.
- These findings highlight the need for specialized, long-term follow-up care.
Objective:
To compare long-term neurodevelopmental and functional outcomes of neonatal intensive care unit (NICU) survivors with neonatal intraparenchymal echodensities (IPE) with porencephaly on cranial ultrasonography with matched controls. To compare the developmental trajectories of these infants over the childhood years with those of matched controls.
Design:
Cohort study.
Setting:
Tertiary level NICU and the Neonatal Follow-Up Programme (NFUP) in Vancouver, Canada.
Patients:
NICU survivors with birth weights <1250 g, born between 1983 and 1985.
Methods:
Cranial ultrasound scans of NICU subjects with grade 4 intraventricular haemorrhage (IVH) were reviewed by a neuroradiologist and cases were defined, using stringent criteria, as IVH with IPE with porencephaly. Controls with normal cranial ultrasound findings were selected case-matched for birth weight and sex. Prospective sequential multidisciplinary assessments were performed up to 17 years in the NFUP. Mann-Whitney U test was used to compare outcomes between cases and controls.
Results:
Of 385 eligible patients, 14 met IPE and porencephaly criteria and 10 survived to discharge. All cases with IPE and porencephaly had one or more impairments, significantly different from preterm controls (p<0.001). At all ages assessed, rates of motor, cognitive and overall impairment were significantly higher in the cases (p< or =0.002 for all tests). Most cases at adolescence were ambulatory, required learning assistance in school and had social challenges.
Conclusions:
Children with neonatal IPE and porencephaly have a much worse long-term neurodevelopmental outcome than children with normal cranial ultrasound findings.
