121 EEG DEPRESSIOKTAND GERMINAL LAYER HEMORRHAGE GLH

Abstract

Amplitude integrated EEG (aEEG) was recorded between 24 and 50 hrs after birth in 32 newborns with 32 weeks gestational age or less. Germinal layer haemorrhage (GLH) was diagnosed by repeated ultra-sonography. In the six infants with neither GLH nor hypocalcemia continuous background activity was present in more than 20% of the time at 30 h, and seizure-like activity was exceptional in contrast to the rest. In 7 infants without GLH but with hypocalcemia continuous background activity appeared later. In all 4 infants who later developed FLH, EEG was depressed at 30 h. A further EEG depression occurred concurrently with the development of GLH grade II-IV.In 15 of the infants the EEG recording was started before 6 h in the absence of GLH. In 7 of these, mean internal carotid flow velocity (cMFV, Doppler) more than doubled concurrently with increases in arterial blood pressure (aBP). GLH developed more frequently in this group compared to the remaining 8 infants (p = 0.039). The increase in aBP and cMFV was preceeded by lower aBP, cMFV, and cMFV.We suggest that GLH primarily occurs in cerebrovascularly unstable infants (lost autoregulation) with preceeding cerebral metabolic and electrophysiologic derangement unrelated to present energy supply, and that further functional deterioration is caused by the most severe haemorrhages.