title: The premature brain: developmental and lesional anatomy.
abstract: BACKGROUND
  Neurodevelopmental outcome in prematures who suffer from a neonatal brain injury depends on the lesion itself, and on how the lesion interferes with the still developing functional anatomy.
  
  
  METHODS
  Most of the neuronal migration is completed by midgestation. The second part of the gestation corresponds to the development of the connectivity and sulcation, of the maturation of the oligodendrocytic lineage and of the microglia, and of the vascular bed in the parenchyma beyond the germinal matrix.
  
  
  RESULTS
  In this paper, the main processes of the developmental anatomy of the premature brain are reviewed, and are correlated with the findings in a prospective series of 105 premature infants born between 24 and 32 weeks of gestation, and serially examined with MR imaging at birth, at term-equivalent age, at 2 years, and at 4 years. Special emphasis was placed (1) on the intraventricular hemorrhage because of the resulting destruction of the germinal matrix and its impact on the late cellular production, (2) on the periventricular venous hemorrhagic infarction because of the selective destruction of the intermediate zone which is associated, and (3) on the apparently perivenous punctate lesions of the white matter because they involve the intermediate zone also, because they have no convincing explanation yet, and because the microglia seems to be associated with their pathogenesis.
  
  
  CONCLUSIONS
  These deep venous injuries appear to preserve the subplate zone, which is likely to be a significant element to consider in the perspective of the neurodevelopmental outcome.
authors.affiliation: Division of Neuroradiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada. charles.raybaud@sickkids.ca
authors.forename: Charles
authors.initials: C
authors.lastname: Raybaud
authors.forename: Tahani
authors.initials: T
authors.lastname: Ahmad
authors.forename: Neda
authors.initials: N
authors.lastname: Rastegar
authors.forename: Manohar
authors.initials: M
authors.lastname: Shroff
authors.forename: Mutaz
authors.initials: M
authors.lastname: Al Nassar
mesh_terms: D001921:Brain / Q000254:growth & development* / Q000473:pathology*; D001930:Brain Injuries / Q000473:pathology*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development*; D007235:Infant, Premature, Diseases / Q000473:pathology* / Q000503:physiopathology*; D008953:Models, Anatomic; D008959:Models, Neurological