Disruption of Cerebellar Development: Potential Complication of Extreme Prematurity
Agnes Messerschmidta,
Peter C. Bruggerb,
Eugen Boltshauserf,
Gerlinde Zoderd,
Walter Sternistee,
Robert Birnbachera and
Daniela Prayerc
a Department of Neonatology and Pediatric Intensive Care, University Children’s Hospital, Vienna, Austria
b Center of Anatomy and Cell Biology, Integrative Morphology Group, Vienna, Austria
c Department of Neuroradiology, University Clinics of Radiodiagnostics, Vienna, Austria
d Medical University of Vienna, Kinderklinik der Stadt Wien, Glanzing im Wilhelmenspital, Vienna, Austria
e Pediatric Department of the Danube Hospital/SMZO, Vienna, Austria
f Department of Neurology, University Children’s Hospital, Zurich, Switzerland
View larger version (46K):
[in a new window]
|
FIG 1. Coronal sonograms in a preterm neonate born at 27 + 5 gestational weeks.
A, Scan on day 1 of life shows normal cerebellar hemispheres.
B, Scan at 3 weeks shows reduced cerebellar volume.
| |
View larger version (115K):
[in a new window]
|
FIG 2. Type 2 disrupted cerebellar development in a preterm infant born at 26 + 3 gestational weeks.
A–C, Sagittal follow-up sonograms obtained on days 57 (A), 86 (B), and 106 (C) of life show a vanishing cerebellar vermis with successive enlargement of the fourth ventricle.
D, MR image obtained at 15 weeks.
| |
View larger version (43K):
[in a new window]
|
FIG 3. Type 1 disrupted cerebellar development in a preterm infant born at 29 gestational weeks. T1-weighted MR imaging was performed at 7 months.
A, Sagittal image shows normal configuration of the fourth ventricle, a thin corpus callosum, and an inclined tentorium. The vermis is small but normally shaped. Dimensions of the brain stem are reduced.
B and C, Parasagittal (B) and (C) frontal images demonstrate small cerebellar hemispheres immediately beneath the tentorium.
| |
View larger version (48K):
[in a new window]
|
FIG 4. Type 2 disrupted cerebellar development.
A, Sagittal T2-weighted image shows a balloon-shaped fourth ventricle; a longitudinal, small vermis; and remarkable kinking of the brainstem.
B and C, Parasagittal T2-weighted (B) and frontal T1-weighted (C) images show small cerebellar hemispheres laterally located in the posterior fossa.
| |
View larger version (80K):
[in a new window]
|
FIG 5. Type 3 disrupted cerebellar development in a preterm infant born at 26 + 4 gestational weeks. T2-weighted images show a skeletonized appearance of the cerebellum.
A, Sagittal image.
B, Parasagittal image.
| |
View larger version (152K):
[in a new window]
|
FIG 6. Unclassified pattern in a preterm infant (patient 26) born at 24 + 6 gestational weeks. Images show different blood breakdown products in the posterior fossa, shrunken cerebellar hemispheres, and cystic pontine (arrow) and vermian lesions.
A, Sagittal T1-weighted image.
B, Axial T2-weighted image.
C, Axial T2*-weighted image.
D, Coronal T1-weighted image.
| |
