EEG and the neuropathology in premature neonates with intraventricular hemorrhage

Eighty-eight EEGs from 32 premature neonates with autopsy-verified periventricular-intraventricular hemorrhage (PVH-IVH) were compared with associated neuropathological findings. PVH-IVH was rarely an isolated lesion at autopsy. Twenty-seven infants (84%) had additional parenchymal brain lesions, such as periventricular leukomalacia (47%), ischemic neuronal necrosis (22%), pontosubicular necrosis (22%), cerebral infarction (13%), and/or cerebellar hemorrhage (13%). A significant correlation was found between the patient's most abnormal EEG and the severity of morphological changes. Infants with more abnormal EEGs had more extensive brain lesions. On the other hand, IVH grade did not correlate with the degree of parenchymal brain lesions, with the exception of IVH with intraparenchymal involvement. Positive rolandic sharp wave transients (PRS) were observed in eight patients (25%). All infants with PRS had white matter lesions. The sensitivity of PRS for white matter lesions, however, was only 38%. EEG has limited value in the diagnosis of PVH-IVH or specific anatomical changes but provides useful electrographic information that correlates with the severity of brain damage in infants with PVH-IVH.