Differential effects of intraventricular hemorrhage and white matter injury on preterm cerebellar growth.
OBJECTIVE
To hypothesize that detailed examination of early cerebellar volumes in time would distinguish differences in cerebellar growth associated with intraventricular hemorrhage (IVH) and white matter injury in preterm infants.


METHODS
Preterm newborns at the University of California San Francisco (n = 57) and the University of British Columbia (n = 115) were studied with serial magnetic resonance imaging scans near birth and again at near term-equivalent age. Interactive semi-automated tools were used to determine volumes of the cerebellar hemispheres.


RESULTS
Adjusting for supratentorial brain injury, cerebellar hemorrhage, and study site, cerebellar volume increased 1.7 cm(3)/week postmenstrual age (95% CI, 1.6-1.7; P < .001). More severe supratentorial IVH was associated with slower growth of cerebellar volumes (P < .001). Volumes by 40 weeks were 1.4 cm(3) lower in premature infants with grade 1 to 2 IVH and 5.4 cm(3) lower in infants with grade 3 to 4 IVH. The same magnitude of decrease was found between ipsilateral and contralateral IVH. No association was found with severity of white matter injury (P = .3).


CONCLUSIONS
Early effects of decreased cerebellar volume associated with supratentorial IVH in either hemisphere may be a result of concurrent cerebellar injury or direct effects of subarachnoid blood on cerebellar development.
Tam
Emily W Y
EW
Department of Neurology, University of California San Francisco, CA, USA.
Miller
Steven P
SP
Studholme
Colin
C
Chau
Vann
V
Glidden
David
D
Poskitt
Kenneth J
KJ
Ferriero
Donna M
DM
Barkovich
A James
AJ
D001930:Brain Injuries / Q000473:pathology*; D002531:Cerebellum / Q000098:blood supply / Q000254:growth & development* / Q000293:injuries; D002552:Cerebral Ventricles; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007231:Infant, Newborn; D007234:Infant, Premature; D020300:Intracranial Hemorrhages / Q000473:pathology*; D056784:Leukoencephalopathies / Q000473:pathology*; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009929:Organ Size; D012044:Regression Analysis