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Antenatal post-hemorrhagic ventriculomegaly: a prospective follow-up study
R Luciano1, G Baranello, L Masini
1Neonatology, Catholic University, Rome, Italy.
Insights
Infants with antenatal cerebral ventriculomegaly and intraventricular hemorrhage (IVH) showed varied outcomes. Associated brain lesions and early epilepsy indicated a poorer prognosis for neurodevelopmental impairment.
Area of Science:
- Neonatal neurology
- Developmental pediatrics
- Neuroimaging
Background:
- Antenatal onset cerebral ventriculomegaly associated with intraventricular hemorrhage (IVH) can impact infant neurodevelopment.
- Early identification and assessment are crucial for managing potential neurological deficits.
Purpose of the Study:
- To assess neurological and cognitive impairment at 2 years in infants with antenatal ventriculomegaly and IVH.
- To identify prognostic markers for neurodevelopmental outcomes in this cohort.
Main Methods:
- Evaluated 16 infants (9 term, 7 preterm) diagnosed with antenatal ventriculomegaly and IVH.
- Utilized serial ultrasound, neonatal imaging, Hammersmith infant neurological examination, and Griffiths developmental scales at 2 years.
Main Results:
- At 2 years, 8 infants had normal motor function, while 8 developed cerebral palsy.
- Severity of ventriculomegaly did not consistently correlate with the degree of impairment.
- Associated brain lesions and early-onset epilepsy were linked to adverse neurodevelopmental outcomes.
Conclusions:
- Associated lesions and early epilepsy are significant negative prognostic indicators in infants with antenatal ventriculomegaly and IVH.
- Neurodevelopmental outcomes are complex and not solely predicted by the degree of ventricular dilatation.
Objective:
The aim of this study was to evaluate the presence and the severity of neurological and cognitive impairment at 2 years of age in 16 infants (9 term born, 7 preterm of mean gestation 33.6 weeks) with cerebral ventriculomegaly of antenatal onset associated with intraventricular haemorrhage.
Methods:
Ventricular dilatation, with or without associated lesions, was, with one exception, not identified on the antenatal routine scan at approximately 22 weeks but was obvious on the scans performed between weeks 27 and 33. In 8 of the 16 cases there were signs of parenchymal involvement or of abnormalities of the corpus callosum or cerebellum. In all patients the diagnosis of antenatal IVH was confirmed by early neonatal imaging. Outcome was measured using the Hammersmith infant neurological examination and the Griffiths developmental scales at 2 years.
Results And Conclusions:
At 2 years, 8 infants had normal motor outcome and 8 had cerebral palsy. The presence and severity of cerebral palsy or neurodevelopmental delay was not always related to the magnitude or symmetry of the ventricular dilatation per se. The presence of associated lesions was a negative prognostic marker. The early development of epilepsy was also associated with an abnormal outcome.
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