engleski

Hypoxic-ischemic lesions of periventricular crossroads of pathways decrease the thickness of corpus callosum

Periventricular white matter is the most vulnerable site in perinatal brain. Lesions of periventricular white matter frequently occur in preterm infants, and are associated with hypoxia-ischemia. They damage periventricular crossroads of commissural, associative and projectional pathways (PCP), and are associated with co-occurrence of motor, sensory and cognitive deficits (Judas et al. AJNR vol.26, 2005). The aim was to analyze the relationship between lesions of PCP areas and corpus callosum (CC) size. The study included sixteen infants (gestational age 24-41 weeks). Areas of frontal, main and occipital PCP were visualized by ultrasound scans (US), performed during the first 10 postnatal days. Echogenicity of white matter on US was graded on linear analog scale from 0 to 3, compared to choroid plexus echogenicity. Magnetic resonance imaging was performed at term equivalent age (40-49 weeks corrected age), CC was delineated on the midsagittal section and segmented into 99 rostrocaudal segments. The segment widths were measured. Depending on the sum of all PCP areas, infants were divided into: mildly-lesioned group (total score 5 or less) and severely-lesioned group (total score 6 or more). We correlated total score with CC segment widths, between the groups. The severely-lesioned group showed a significant decrease in widths of segments 80-92. In addition, analysis of individual PCP area scores and CC segment widths showed a significant correlation between frontal PCP areas and segments 19-70. The extent of white matter damage is most prominent in occipital white matter areas, as seen on US, and is significantly correlated with a decrease of caudal segments of CC. An additional finding is that damage of frontal PCP areas is associated with a decrease of the central part of CC. In conclusion, damage of PCP areas affects the size of CC in a topographical manner.

hypoxic-ischemic lesion; corpus callosum; crossroads of pathways; magnetic resonance; ultrasound

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