Differential effects of intraventricular hemorrhage and white matter injury on preterm cerebellar growth

J Pediatr. 2011 Mar;158(3):366-71. doi: 10.1016/j.jpeds.2010.09.005. Epub 2010 Oct 20.

Abstract

Objective: To hypothesize that detailed examination of early cerebellar volumes in time would distinguish differences in cerebellar growth associated with intraventricular hemorrhage (IVH) and white matter injury in preterm infants.

Study design: Preterm newborns at the University of California San Francisco (n = 57) and the University of British Columbia (n = 115) were studied with serial magnetic resonance imaging scans near birth and again at near term-equivalent age. Interactive semi-automated tools were used to determine volumes of the cerebellar hemispheres.

Results: Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm(3)/week postmenstrual age (95% CI, 1.6-1.7; P < .001). More severe supratentorial IVH was associated with slower growth of cerebellar volumes (P < .001). Volumes by 40 weeks were 1.4 cm(3) lower in premature infants with grade 1 to 2 IVH and 5.4 cm(3) lower in infants with grade 3 to 4 IVH. The same magnitude of decrease was found between ipsilateral and contralateral IVH. No association was found with severity of white matter injury (P = .3).

Conclusions: Early effects of decreased cerebellar volume associated with supratentorial IVH in either hemisphere may be a result of concurrent cerebellar injury or direct effects of subarachnoid blood on cerebellar development.

Publication types

  • Comparative Study
  • Multicenter Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain Injuries / pathology*
  • Cerebellum / blood supply
  • Cerebellum / growth & development*
  • Cerebellum / injuries
  • Cerebral Ventricles*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Infant, Newborn
  • Infant, Premature*
  • Intracranial Hemorrhages / pathology*
  • Leukoencephalopathies / pathology*
  • Longitudinal Studies
  • Magnetic Resonance Imaging
  • Male
  • Organ Size
  • Regression Analysis