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Neurodevelopmental outcome in survivors of periventricular hemorrhagic infarction

Haim Bassan1, Catherine Limperopoulos, Karen Visconti

  • 1Department of Neurology, Children's Hospital and Harvard Medical School, 300 Longwood Ave, Boston, MA 02115, USA.

Pediatrics
|October 3, 2007
PubMed

Insights

Periventricular hemorrhagic infarction (PHI) survivors often face cognitive and motor challenges. A higher PHI severity score on early ultrasounds predicts worse neurodevelopmental outcomes in premature infants.

Area of Science:

  • Neonatal neurology
  • Pediatric neurodevelopment
  • Medical imaging in neonates

Background:

  • Periventricular hemorrhagic infarction (PHI) is a severe complication of germinal matrix-intraventricular hemorrhage in premature infants.
  • Understanding long-term outcomes and early predictors is crucial for managing affected infants.

Purpose of the Study:

  • To assess neurodevelopmental and adaptive outcomes in PHI survivors.
  • To identify early cranial ultrasound predictors of adverse outcomes in these infants.

Main Methods:

  • Retrospective analysis of cranial ultrasounds in 30 premature infants with PHI.
  • Development of a PHI severity score based on ultrasound findings (territory involvement, bilaterality, midline shift).
  • Neuromotor, visual, and developmental assessments using standardized scales (Mullen, Vineland).

Main Results:

  • 60% of survivors had abnormal muscle tone, and 26% had visual field defects.
  • Significant developmental delays were observed in gross motor (73%), fine motor (59%), visual receptive (46%), expressive language (38%), and cognitive (50%) domains.
  • Higher PHI severity scores correlated with microcephaly and poorer outcomes in gross motor, visual receptive, and cognitive functions.

Conclusions:

  • Two-thirds of PHI survivors experience significant cognitive and/or motor impairments.
  • Adaptive skills appear relatively preserved compared to cognitive and motor functions.
  • The cranial ultrasound-based PHI severity score is a valuable tool for predicting neurodevelopmental outcomes.
Abstract

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