229 Fetal Post-Haemorrhagic Ventriculomegaly: Neurological Outcome At 24 Months

Abstract

Background: Intraventricular hemorrhage (IVH), a common event in preterm infants, may also occur in utero with a suggested estimate of 1–5 in 10000 pregnancies. A high incidence of sequelae is reported in survivors but the data available so far have not been sistematically and prospectively collected with a structered assessment. The aim of this prospective study was to evaluate the presence and the severity of neurological and neurovisual impairment in a cohort of 13 infants with antenatal IVH and post-haemorrhagic ventriculomegaly.Methods: All 13 infants have been regularly followed for at least 24 months with a standardized assessment. This included the Griffiths mental scales and a battery of age specific tests assessing cerebral visual function.Results: Nine of the 13 infants developed post-haemorrhagic hydrocephalus (PHH) and underwent ventriculo-peritoneal shunting, the remaining four had a not hypertensive ventricular dilatation. Eight infants had hemorrhagic and/or ischemic parenchimal lesions (7 of them developed PHH): All of them showed abnormal visual function, associated in all but one with severe neurological impairment. Five infants had no evidence of parenchimal lesions (2 of them developed PHH): No neurologic impairment was found in this group but neurovisual anomalies were evident in two patients (1 of them with PHH).Conclusions: Seven of the 13 infants included in the study (53,8%) showed neurological sequelae and ten of them (76,9%) abnormalities in neurovisual function. Cerebral visual anomalies were found in three infant with no neurological impairment or no evidence of parenchimal involvement. An early screening of neurovisual function is recommended in order to provide an adequate rehabilitation programme in this high risk group of patients.