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Published on: November 20, 2015
The premature brain: developmental and lesional anatomy
Charles Raybaud1, Tahani Ahmad, Neda Rastegar
1Division of Neuroradiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. charles.raybaud@sickkids.ca
Neuroradiology
|July 9, 2013
Summary
Neonatal brain injuries in premature infants can impact neurodevelopment. Deep venous injuries may preserve the subplate zone, potentially improving outcomes for preterm infants with brain damage.
Area of Science:
- Neuroscience
- Developmental Biology
- Neonatal Medicine
Background:
- Premature infants with neonatal brain injury face variable neurodevelopmental outcomes.
- Outcome is influenced by lesion characteristics and interference with developing brain anatomy.
Purpose of the Study:
- Review key developmental anatomy processes in premature brains.
- Correlate these processes with MR imaging findings in a cohort of preterm infants.
- Investigate specific brain lesions and their pathogenetic mechanisms.
Main Methods:
- Prospective study of 105 premature infants (24-32 weeks gestation).
- Serial MR imaging at birth, term-equivalent age, 2, and 4 years.
- Focus on intraventricular hemorrhage, periventricular venous hemorrhagic infarction, and white matter punctate lesions.
Main Results:
- Intraventricular hemorrhage impacts germinal matrix and late cellular production.
- Periventricular venous hemorrhagic infarction selectively destroys the intermediate zone.
- Perivenous punctate white matter lesions involve the intermediate zone, with potential microglia involvement.
Conclusions:
- Deep venous injuries appear to spare the subplate zone.
- Preservation of the subplate zone is a significant factor for neurodevelopmental outcomes in preterm infants.
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