Cranial ultrasound lesions in the NICU predict cerebral palsy at age 2 years in children born at extremely low gestational age.
Our prospective cohort study of extremely low gestational age newborns evaluated the association of neonatal head ultrasound abnormalities with cerebral palsy at age 2 years. Cranial ultrasounds in 1053 infants were read with respect to intraventricular hemorrhage, ventriculomegaly, and echolucency, by multiple sonologists. Standardized neurological examinations classified cerebral palsy, and functional impairment was assessed. Forty-four percent with ventriculomegaly and 52% with echolucency developed cerebral palsy. Compared with no ultrasound abnormalities, children with echolucency were 24 times more likely to have quadriparesis and 29 times more likely to have hemiparesis. Children with ventriculomegaly were 17 times more likely to have quadriparesis or hemiparesis. Forty-three percent of children with cerebral palsy had normal head ultrasound. Focal white matter damage (echolucency) and diffuse damage (late ventriculomegaly) are associated with a high probability of cerebral palsy, especially quadriparesis. Nearly half the cerebral palsy identified at 2 years is not preceded by a neonatal brain ultrasound abnormality.
Kuban
Karl C K
KC
Division of Pediatric Neurology, Department of Pediatrics, Boston Medical Center, Boston University, Boston, Massachusetts, USA. karl.kuban@bmc.org
Allred
Elizabeth N
EN
O'Shea
T Michael
TM
Paneth
Nigel
N
Pagano
Marcello
M
Dammann
Olaf
O
Leviton
Alan
A
Du Plessis
Adré
A
Westra
Sjirk J
SJ
Miller
Cindy R
CR
Bassan
Haim
H
Krishnamoorthy
Kalpathy
K
Junewick
Joseph
J
Olomu
Nicholas
N
Romano
Elaine
E
Seibert
Joanna
J
Engelke
Steve
S
Karna
Padmani
P
Batton
Daniel
D
O'Connor
Sunila E
SE
Keller
Cecelia E
CE
D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000473:pathology; D002547:Cerebral Palsy / Q000175:diagnosis* / Q000209:etiology; D002675:Child, Preschool; D015331:Cohort Studies; D016001:Confidence Intervals; D002658:Developmental Disabilities / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D006257:Head / Q000002:abnormalities* / Q000000981:diagnostic imaging*; D006801:Humans; D052577:Infant, Extremely Low Birth Weight; D007231:Infant, Newborn; D007363:Intensive Care Units, Neonatal / Q000706:statistics & numerical data*; D008279:Magnetic Resonance Imaging; D008297:Male; D009043:Motor Activity / Q000502:physiology; D009460:Neurologic Examination / Q000379:methods; D011597:Psychomotor Performance / Q000502:physiology; D014463:Ultrasonography