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Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale
19:15

Assessment and Evaluation of the High Risk Neonate: The NICU Network Neurobehavioral Scale

Published on: August 25, 2014

Neurologic outcome of prematurity

J J Volpe1

  • 1Harvard Medical School and Children's Hospital, Boston, Mass 02115, USA. volpe_j@a1.tch.harvard.edu

Archives of Neurology
|March 31, 1998
PubMed

Insights

Preventing brain injury in premature infants is achievable. Strategies include avoiding germinal matrix-intraventricular hemorrhage and managing impaired cerebral blood flow to prevent periventricular leukomalacia.

Area of Science:

  • Neonatal neurology
  • Pediatric neuropathology

Background:

  • Brain injury is a significant concern in premature infants.
  • Key lesions include periventricular hemorrhagic infarction and periventricular leukomalacia.
  • These lesions cause subsequent neurological deficits.

Purpose of the Study:

  • To review neuropathological features, pathogenesis, and prevention strategies for two main brain lesions in premature infants.
  • To highlight recent advancements suggesting lesion prevention is possible.

Main Methods:

  • Review of neuropathological findings.
  • Analysis of pathogenetic mechanisms.
  • Evaluation of potential preventative interventions.

Main Results:

  • Periventricular hemorrhagic infarction may be prevented by avoiding germinal matrix-intraventricular hemorrhage.
  • Periventricular leukomalacia prevention involves detecting impaired cerebrovascular autoregulation and cerebral blood flow.
  • Interrupting oligodendroglial cell death pathways, possibly with free radical scavengers, is a target for periventricular leukomalacia.

Conclusions:

  • Prevention of germinal matrix-intraventricular hemorrhage can reduce periventricular hemorrhagic infarction.
  • Targeting cerebrovascular regulation and cell death pathways offers hope for preventing periventricular leukomalacia.
  • Achieving lesion prevention in premature infants is a realistic goal.

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