Serial MRI and neurodevelopmental outcome in 9- to 10-year-old children with neonatal encephalopathy.
OBJECTIVE
To assess the relation between patterns of brain injury on neonatal and childhood magnetic resonance imaging (MRI) and long-term neurodevelopmental outcome.


METHODS
Neonatal (n = 34) and childhood MRIs (n = 77) were analyzed for 80 children with neonatal encephalopathy and for 51 control subjects during childhood. MRIs were graded as normal, mildly abnormal (white matter lesions), or moderately/severely abnormal (watershed injury, lesions in basal ganglia/thalamus or focal infarction). Severity of brain injury was related to different aspects of neurologic outcome: Total impairment score of the Movement Assessment Battery for Children, intelligence quotient score, cerebral palsy, postneonatal epilepsy, and need for special education. Seven children with neonatal encephalopathy required extracorporeal membrane oxygenation treatment.


RESULTS
Neonatal and childhood MRI were comparable in 25/33 children (75.8%, P < .001). Children with moderate/severe lesions on neonatal or childhood MRI more often had a total impairment score <or= 15th percentile, an intelligence quotient <or= 85, and cerebral palsy, and attended special education.


CONCLUSIONS
Different patterns of injury seen on neonatal MRI after neonatal encephalopathy can still be recognized on childhood MRI. Children with moderate to severe brain lesions on neonatal or childhood MRI significantly more often have impaired motor and cognitive outcomes.
van Kooij
Britt J M
BJ
Department of Neonatology, University Medical Center, Utrecht, The Netherlands.
van Handel
Mariëlle
M
Nievelstein
Rutger A J
RA
Groenendaal
Floris
F
Jongmans
Marian J
MJ
de Vries
Linda S
LS
D001238:Asphyxia Neonatorum / Q000503:physiopathology; D001927:Brain Diseases / Q000175:diagnosis* / Q000503:physiopathology; D001930:Brain Injuries / Q000175:diagnosis* / Q000503:physiopathology; D016022:Case-Control Studies; D002547:Cerebral Palsy / Q000175:diagnosis; D002648:Child; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D007361:Intelligence Tests; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D012306:Risk; D016896:Treatment Outcome