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24 - Hemorrhagic lesions of the central nervous system

from Section 4 - Specific conditions associated with fetal and neonatal brain injury

Published online by Cambridge University Press:  12 January 2010

By
Linda S. de Vries
Edited by
David K. Stevenson ,
William E. Benitz ,
Philip Sunshine ,
Susan R. Hintz  and
Maurice L. Druzin
David K. Stevenson
Affiliation:
Stanford University School of Medicine, California
William E. Benitz
Affiliation:
Stanford University School of Medicine, California
Philip Sunshine
Affiliation:
Stanford University School of Medicine, California
Susan R. Hintz
Affiliation:
Stanford University School of Medicine, California
Maurice L. Druzin
Affiliation:
Stanford University School of Medicine, California
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Summary

Intracranial hemorrhage in preterm infants

During the last decade, attention has increasingly been drawn to ischemic damage occurring in the periventricular white matter (PWMI, periventricular white-matter injury), compared to the early days of neonatal imaging, when the focus was on intracranial hemorrhage (ICH). This is due to improvements in neonatal brain imaging, from only having access to cranial ultrasound (US) and computed tomography (CT) in the early 1980s, to increased use of magnetic resonance imaging (MRI) at present. The majority of the neonatal MRI studies have focused on lesions in the white matter, especially the more subtle lesions, which can now be clearly visualized; this was not so easy, and certainly more subjective, when imaging was restricted to cranial ultrasound. With better ultrasound equipment and more detailed examinations, using more acoustic windows than the anterior fontanel, for example the mastoid window and the posterior fontanel, hemorrhagic lesions of the cerebellum have increasingly been recognized, especially in the very immature and extremely low-birthweight infant. Germinal matrix hemorrhage–intraventricular hemorrhage (GMH–IVH) is still common, and especially the severe hemorrhages can lead to adverse neurologic sequelae.

Type
Chapter
Information
Fetal and Neonatal Brain Injury , pp. 285 - 295
Publisher: Cambridge University Press
Print publication year: 2009

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