Ultrasonically detectable cerebellar haemorrhage in preterm infants.
OBJECTIVE
To determine the frequency and pattern of cerebellar haemorrhage (CBH) on routine cranial ultrasound (cUS) imaging in infants of ≤32 weeks gestation, and to investigate how extremely preterm infants with CBH differ from those with severe intraventricular haemorrhage (IVH).


METHODS
672 infants of ≤32 weeks gestation were prospectively examined for CBH on serial cUS imaging. In a separate case--control analysis, the clinical features, ultrasound findings and outcome of preterm infants with CBH were compared to those of infants with isolated severe IVH (grade III-IV).


RESULTS
Nine cases of CBH were identified among 53 infants with severe IVH. The incidence of CBH in infants of ≤32 weeks gestation was 1.3%. Five infants had bilateral CBH involving both hemispheres, three had unilateral left sided CBH and one had a right hemispheric lesion. Infants with CBH were male, significantly more preterm (24.4 vs 27.0 weeks) and of lower birth weight (692 g vs 979 g). Vaginal births predominated in the CBH group (89% vs 50%). The median time to identification of haemorrhage for both groups was 3 days. Mortality in the CBH group was 100% (9/9) compared to 43% (19/44) in the severe IVH group.


CONCLUSIONS
Extensive CBH in preterm infants is rare and devastating. It appears to be confined to very preterm, extremely low birthweight infants and may have a male predominance. The co-existence of severe IVH and extensive CBH on routine cot-side cUS in the early neonatal period is an ominous finding.
Department of Neonatology, The National Maternity Hospital, Dublin, Ireland. lmccarthy@nmh.ie
Lisa Kenyon
LK
McCarthy
V
V
Donoghue
J F A
JF
Murphy
D001724:Birth Weight; D016022:Case-Control Studies; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging*; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D007363:Intensive Care Units, Neonatal; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D012737:Sex Factors; D014463:Ultrasonography