PDF herunterladen
Am J Perinatol 2001; 18(2): 079-086
DOI: 10.1055/s-2001-13633
ORIGINAL ARTICLES

Copyright © 2001 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA. Tel.: +1(212) 584-4662

Late-Onset Cystic Periventricular Leukomalacia in Premature Infants: A Threat Until Term

Patrick André1 , Bernard Thébaud1 , Jocelyne Delavaucoupet2 , Véronique Zupan1 , Nathalie Blanc1 , Anne Marie d'Allest3 , Caroline Rambaud4 , Michel Dehan1 , Thierry Lacaze-Masmonteil1
  • 1Service de Pédiatrie et Réanimation Néonatale, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
  • 2Service de Radiologie, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
  • 3Service des Explorations Fonctionnelles, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
  • 4Service d'Anatomie Pathologique, Hôpital Antoine Béclère, Assistance Publique-Hôpitaux de Paris, Université Paris-Sud, Clamart, France
Weitere Informationen

Publikationsverlauf

Publikationsdatum:
31. Dezember 2001 (online)

Auch verfügbar auf
    Lizenzen und Reprints

ABSTRACT

The purposes of this study are (1) to describe a ``late-onset'' form of cystic periventricular leukomalacia eventually appearing in premature infants whose neurological assessments were normal in the first month of life; (2) to retrospectively evaluate its incidence among a large population of premature infants; (3) to suggest that a few unexpected complications of prematurity may trigger the development of white matter damage, even several weeks after birth. Retrospective study in a population of 1452 surviving infants after 5 days born before 33 weeks. We identified 10 cases of late-onset cystic periventricular leukomalacia appearing beyond the first 5 weeks of life. In 8 cases, an intercurrent event associated with a systemic inflammatory response preceded the appearance of cysts: necrotizing enterocolitis (n = 5), septicemia (n = 2 cases), strangulated inguinal hernia in one infant. Neurological surveillance should be repeated until discharge in very preterm infants, especially after the occurrence of an intercurrent complication coming along with a systemic inflammatory response.

KEYWORD

Periventricular leukomalacia - white matter damage - preterm infant - cerebral palsy

REFERENCES

  • 1 Volpe J J. Neurology of the newborn.  3rd ed. Philadelphia: WB Saunders; 1995
    Suche in Google Scholar
  • 2 Kuban K C, Leviton A. Cerebral palsy.  N Engl J Med . 1994;  330 188-195
    CrossrefPubMedSuche in Google Scholar
  • 3 Zupan V, Gonzalez P, Lacaze-Masmonteil T. Periventricular leukomalacia: risk factors revisited.  Dev Med Child Neurol . 1996;  38 1061-1067
    PubMedSuche in Google Scholar
  • 4 Dammann O, Leviton A. Duration of transient hyperechoic images of white matter in very-low-birth-weight infants: a proposed classification.  Dev Med Child Neurol . 1997;  39 2-5
    PubMedSuche in Google Scholar
  • 5 Marret S, Parain D, Samson-Dollfus D, Jeannot E, Fessard C. Positive rolandic sharp waves and periventricular leukomalacia in the newborn.  Neuropediatrics . 1986;  17 199-202
    PubMedSuche in Google Scholar
  • 6 Baud O, d'Allest A M, Lacaze-Masmonteil T. The early diagnosis of periventricular leukomalacia in premature infants with positive rolandic sharp waves on serial electroencephalography.  J Pediatr . 1998;  132 813-817
    PubMedSuche in Google Scholar
  • 7 Perlman J M, Risser R, Broyles R S. Bilateral cystic periventricular leukomalacia in the premature infant: associated risk factors.  Pediatrics . 1996;  97 822-872
    PubMedSuche in Google Scholar
  • 8 Dammann O, Allred E N, Veelken N. Increased risk of spastic diplegia among very low birth weight children after preterm labor or prelabor rupture of membranes.  J Pediatr . 1998;  132 531-535
    PubMedSuche in Google Scholar
  • 9 Blume W T, Dreyfus-Brisac C. Positive rolandic sharp waves in neonatal EEG: types and significance.  Electroencephalogr Clin Neurophysiol . 1982;  53 277-282
    PubMedSuche in Google Scholar
  • 10 De Vries S L, Regev R, Dubowitz L MS. Late onset cystic leukomalacia.  Arch Dis Child . 1986;  61 298-299
    PubMedSuche in Google Scholar
  • 11 Dammann O, Leviton A. Maternal intrauterine infection, cytokines and brain damage in the preterm newborn.  Pediatr Res . 1997;  42 1-8
    CrossrefPubMedSuche in Google Scholar
  • 12 Adinolfi M. Infectious diseases in pregnancy, cytokines and neurological impairment: an hypothesis.  Dev Med Child Neurol . 1993;  35 549-553
    PubMedSuche in Google Scholar
  • 13 Yoon B H, Jun J K, Romero R. Amniotic fluid inflammatory cytokines (interleukin-6, interleukin-1beta, and tumor necrosis factor-alpha), neonatal brain white matter lesions, and cerebral palsy.  Am J Obstet Gynecol . 1997;  177 19-26
    CrossrefPubMedSuche in Google Scholar
  • 14 Yoon B H, Romero R, Yang S H. Interleukin-6 concentrations in umbilical cord plasma are elevated in neonates with white matter lesions associated with periventricular leukomalacia.  Am J Obstet Gynecol . 1996;  174 1433-1440
    CrossrefPubMedSuche in Google Scholar
  • 15 Harris M C, Costarino Jr T A, Sullivan J S. Cytokine elevations in critically ill infants with sepsis and necrotizing enterocolitis.  J Pediatr . 1994;  124 105-111
    CrossrefPubMedSuche in Google Scholar
  • 16 Caplan M S, MacKendrick W. Inflammatory mediators and intestinal injury.  Clin Perinatol . 1994;  21 235-246
    PubMedSuche in Google Scholar
  • 17 Vohr B R, Wright L L, Dusick A M. Neurodevelopment and functional outcomes of extremely low birth weight infants in the National Institute of Child Health and Human Developmental Neonatal Research Network, 1993-1994.  Pediatrics . 2000;  105 1216-1226
    CrossrefPubMedSuche in Google Scholar
  • 18 O'Shea T M, Klinepeter K L, Dillard R G. Prenatal events and the risk of cerebral palsy in very low birth weight infants.  Am J Epidemiol . 1998;  147 362-369
    PubMedSuche in Google Scholar
  • 19 Pinto-Martin J A, Riolo S, Cnaan A, Holzman C, Susser M W, Paneth N. Cranial ultrasound prediction of disabling and nondisabling cerebral palsy at age two in a very low birth weight population.  Pediatrics . 1995;  95 249-254
    PubMedSuche in Google Scholar