Abstract
Background: To investigate whether serial morphometric measurements of the brainstem using high resolution trans-foramen-magnum ultrasound (US) in premature neonates correlate with neurological outcomes.Methods: Serial brain ultrasound scans were performed in 36 consecutive preterm infants born at <34 weeks of gestation from birth until term-equivalent age. Two-dimensional brainstem measurements of the pons and medulla oblongata were compared with those in a cohort of 67 healthy full-term newborns. Neurologic assessment of the premature infants was assessed at 5 years of age.Results: Of the 36 preterm infants born between 25 and 34 weeks of gestation, eight had significantly delayed growth profiles in both the pons and medulla and developed neurological sequelae by 5 years of age.Conclusions: Morphometric measurements of the developing brainstem using high resolution trans-foramen-magnum ultrasound (US) may help predict neurological outcome in high-risk neonates, particularly in those who are born extremely premature.
Highlights
The incidence of severe neurologic and developmental disabilities is high in children who were born as extremely preterm infants [1]
Neonatal cranial sonography is traditionally performed through the anterior fontanelle; this approach does not offer good visualization of deep brain structures such as the brainstem and posterior fossa [4]
The 36 premature neonates were divided into two groups, namely a group of 15 extremely premature neonates with gestational ages ranging from 25 to 30 weeks and a group of 21 preterm newborns with gestational ages ranging from 31 to 34 weeks (Table 1)
Summary
The incidence of severe neurologic and developmental disabilities is high in children who were born as extremely preterm infants [1]. Studies have shown that the poor cognitive and behavioral outcomes in many of these children are associated with reduced volumes of specific regions in the brain [2]. Neonatal cranial sonography is traditionally performed through the anterior fontanelle; this approach does not offer good visualization of deep brain structures such as the brainstem and posterior fossa [4]. Studies have shown that better visualization of the neonatal midbrain and posterior fossa can be achieved when sonography is performed through alternative acoustic windows such as the posterior fontanelle, mastoid fontanelle, the temporal suture and the cisterna magnum [4,5,6,7]. To investigate whether serial morphometric measurements of the brainstem using high resolution trans-foramen-magnum ultrasound (US) in premature neonates correlate with neurological outcomes
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