Cerebellar injury in term infants: clinical characteristics, magnetic resonance imaging findings, and outcome.
Although cerebellar injury in the premature infant is an increasingly recognized form of neonatal brain injury, its structural and functional outcomes remain poorly defined in the term infant. The objective of this cross-sectional study was to characterize the clinical and magnetic resonance imaging features and neurodevelopmental outcome in children, born at term, with cerebellar injury. Over a 5-year period, 20 infants were identified with ischemic (n = 3) or hemorrhagic (n = 17) cerebellar injury. Lesions were small (<1 cm) in 12 cases, and large in 8 cases. Prenatal and intrapartum factors frequently documented in term infants with cerebellar injury included primiparity (55%), advanced maternal age (30%), group B streptococcus-positive mothers (35%), abnormal fetal heart rate (35%), instrumented delivery (30%), and cesarean section (25%). At follow-up of 18 cases (median age, 32 months), 39% had neurologic abnormalities. Gross motor delays, expressive language deficits, and externalizing behavioral problems were the most common (44%). Cognitive deficits were present in one third of cases. Larger cerebellar lesions were associated with significantly lower cognitive, gross motor, expressive language, and social-behavioral scores. Cerebellar injury in the term infant is associated with a broad spectrum of neurodevelopmental disabilities, particularly in infants with large cerebellar lesions.
Limperopoulos
Catherine
C
Department of Neurology and Neurosurgery, McGill University, Montreal, Quebec, Canada. catherine.limperopoulos@mcgill.ca
Robertson
Richard L
RL
Sullivan
Nancy R
NR
Bassan
Haim
H
du Plessis
Adré J
AJ
D000367:Age Factors; D002545:Brain Ischemia / Q000150:complications* / Q000209:etiology / Q000473:pathology*; D002531:Cerebellum / Q000293:injuries* / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications* / Q000209:etiology / Q000473:pathology*; D002585:Cesarean Section; D002657:Child Development; D003072:Cognition Disorders / Q000209:etiology; D000075202:Contraindications; D003430:Cross-Sectional Studies; D005113:Extraction, Obstetrical; D005260:Female; D005500:Follow-Up Studies; D006340:Heart Rate, Fetal; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D009035:Mothers; D009422:Nervous System Diseases / Q000209:etiology; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious; D013290:Streptococcal Infections / Q000150:complications; D013292:Streptococcus agalactiae