engleski

Long-term follow up study of children with lower grade peri-intraventricular hemorrhage: neurological and structural outcome

Object: To investigate the long-term neurodevelopmental outcome and structural reorganization of the brain in a cohort of perinatal risk neonates with lower grade peri-intraventricular hemorrhage diagnosed by ultrasound. Methods: One hundred thirty-seven perinatal risk children were multidisciplinary and ultrasonographically followed by the age of 2 years. At age of 13 to 16 years neurodevelopmental outcome was determined by follow-up examination of neurological status (Touwen) and visual acuity (Snellen charts). The information about epilepsy was obtained from EEG findings and medical reports. Morphology of the brain assessed by MR scans, performed on high-resolution 2T machine. Results: Fifty-six children had peri-intraventricular hemorrhage grade I or II according to Papile, of whom long-term follow up were evaluated for 33 children (58, 9%): 12 children was born at <33 weeks’ gestation, 9 at 33-37 weeks and 10 were term. Mean ages at last assessment were 14 years and 2 months (s.d. ± ; 7, 5 months). In none of the children examined cerebral palsy was found, but 22 had minor neurological deficit (66, 7%): 13 MND1 and 9 MND2. Visual impairment was found in thirteen children (39, 4%) and epilepsy or pathologic EEG without seizures in three (9, 1%). Structural changes on MRI scans had 28 children (84, 8%): the most common changes were white matter hyperintensity (78, 8%), ventriculomegaly (57, 6%), reduction in the amount of periventricular white matter (51, 5%) and thinning of corpus callosum (18, 2%). No significant differences were found in long-term neurodevelopmental and structural outcome in depend on weeks’ gestation (p >0, 05). Conclusion: Our results indicated that even children with lower grade peri-intraventricular hemorrhage have relatively high percentage neurological deviant signs as well as brain structural changes. This unexpected high percentage deficits could be explained with concomitant hypoxic-ischemic lesions, present in some of the children examined.

peri-intraventricular haemorrhage; outcome; long-term follow-up

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