Neurologic status and intracranial hemorrhage in very-low-birth-weight preterm infants: outcome at 1 year and 5 years

Article Abstract:

A high number of newborns who have very low birth weights are known to suffer from intracranial hemorrhage (the accumulation of blood outside of blood vessels within the skull). The incidence of intracranial hemorrhage has been reported to range between 40 to 60 percent in these infants. It is associated with both an increased risk of death and profound neurologic defects. Recently the use of ultrasound, the application of sound waves to visualize the brain, has allowed a better and more reliable diagnosis of intracranial hemorrhage in newborns. The purposes of this study were to evaluate very-low-birth-weight preterm infants for intracranial hemorrhage (confirmed by ultrasound) and assess their neurologic development at one and five years of age. Based on ultrasound examination, 17 of the 26 infants were found to be free of intracranial hemorrhage. When 25 of the children were examined at one year, 14 were diagnosed as normal and 11 were classified as either neurologically impaired or suspect. At ages five to six, eight children who tested abnormally at year one continued to show impairment; two of the three children who were suspected of neurological damage at year one continued to be suspect. Of the 15 children diagnosed as normal at one year, six were classified as neurologically suspect by five to six years of age. The findings revealed a correlation between the severity of intracranial hemorrhage and the degree of neurological impairment evident at one year and at later examinations. However, the absence of intracranial hemorrhage did not guarantee normal neurologic development. The one-year assessment was the most accurate predictor of neurologic outcome at ages five to six. Surprisingly, the five- to six-year cognitive outcomes did not correlate with either the severity of the intracranial hemorrhage or with neurologic outcomes at age one. The majority of children in this study had normal intelligence but, many suffered from subtle learning disabilities and motor dysfunctions. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Causes of, Learning disabilities, Learning disorders, Cerebrovascular disease, Cerebrovascular disorders, Brain-damaged children, Pediatric neurology, Cerebrovascular disease in children

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Neurodevelopmental performance of very-low-birth-weight infants with mild periventricular, intraventricular hemorrhage: outcome at 5 to 6 years of age

Article Abstract:

The effect of mild periventricular, intraventricular hemorrhage (grades I and II), or bleeding within the brain ventricles, on neurological development was assessed in 38 infants with very low birth weights. The infants weighed less than 1,501 grams (3.3 pounds) at birth, and were followed from birth to the age of five to six years. They were screened for periventricular, intraventricular hemorrhage at 5 to 10 days of age, and were divided into group 1, consisting of 11 infants with mild periventricular, intraventricular hemorrhage, and group 2, consisting of 27 infants without this complication. All infants were found to have normal neurological development at one to two years of age. A third group was also included; group 3 consisted of infants of similar race, age, sex, and socioeconomic status as the infants with very low birth weights, but the infants in group 3 were born at full term. The children were given tests assessing their cognitive (intellectual) performance, early reading skills, visuomotor integration, and reading potential. At five to six years of age, groups 1 and 2 scored lower than group 3 on combined test measurements and three of four individual measurements. Group 1 scored lower than group 2 on combined test measurements. The findings suggest that infants with very low birth weight have an increased risk of developing learning problems. In addition, mild periventricular, intraventricular hemorrhage can have adverse effects on the global, or total, neurological development of a child. (Consumer Summary produced by Reliance Medical Information, Inc.)

Developmental neurology, Infant development, Cerebral ventricles

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Serum sodium concentration and intraventricular hemorrhage in premature infants

Article Abstract:

The loss of water from brain tissue results in decreased extravascular (outside of blood vessels) pressures within the brain, and may contribute to the development of bleeding within the germinal matrix and ventricles of the brain in premature infants. Blood levels of sodium reflect the hydration status, or water content, of tissue. The importance of high sodium levels and dehydration, or loss of body water, in increasing the risk of germinal matrix/intraventricular hemorrhage was assessed. Two hundred and ninety-nine premature infants weighing less than 1,500 grams (3.3 pounds) at birth were evaluated for blood levels of sodium and germinal matrix/intraventricular hemorrhage during the first four days of life. Intraventricular hemorrhage occurred in 34 of 106 infants with sodium levels of 145 millimoles per liter (mmol/L) or less, and in 54 of 193 infants with sodium levels greater than 145 mmol/L. These findings suggest that blood levels of sodium greater than 145 mmol/L do not increase the risk of germinal matrix/intraventricular hemorrhage in premature infants. Thus, giving more fluids to maintain adequate extravascular pressure within the brain will probably not affect the incidence of bleeding within the germinal matrix and ventricles of the brain. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Diseases, Sodium in the body, Sodium (Nutrient)

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