WHITE MATTER NECROSIS IN VERY-LOW-BIRTH-WEIGHT INFANTS - NEUROPATHOLOGIC AND ULTRASONOGRAPHIC FINDINGS IN INFANTS SURVIVING 6 DAYS OR LONGER
WHITE MATTER NECROSIS IN VERY-LOW-BIRTH-WEIGHT INFANTS - NEUROPATHOLOGIC AND ULTRASONOGRAPHIC FINDINGS IN INFANTS SURVIVING 6 DAYS OR LONGER
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DOI：
10.1016/s0022-3476(05)80664-x
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发表时间：
1990-06-01
影响因子：
5.1
通讯作者：
KAZAM, E
中科院分区：
文献类型：
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作者：
PANETH, N;RUDELLI, R;KAZAM, E
我们描述了22例存活至少6天的极低出生体重儿（平均体重948 gm）的神经病理学和超声检查结果，这些婴儿一生中曾进行过3次或3次以上的头颅超声检查。在22例受试者中的15例中发现了白色物质坏死，7例受试者被判定为慢性（持续5天或更长时间）。最常见的模式是半球白色物质的弥漫性坏死，发现在15个婴儿中的10个;仅在3个婴儿中发现了局限于脑室周围区域的坏死。在15例坏死的婴儿中，7例没有脑室周围白质软化的典型组织学特征。17名婴儿有脑室内出血，但脑室血液延伸到白色物质，不受白色物质坏死的影响：脑实质回声增强和脑室扩大。67%的白色物质坏死的婴儿出现上述一种或两种结果，90%的弥漫性坏死的婴儿出现上述一种或两种结果，但无坏死的婴儿无一例出现上述一种或两种结果。在所有四名出血性坏死的婴儿中，均观察到实质回声增强。我们的结论是，现在在托儿所死亡的非常小的婴儿有一种形式的白色物质损害，是更广泛的，在某些情况下，组织学上不同于，脑室周围白质软化症，如最初描述的。本研究中使用的超声检查确定了大多数但不是所有经病理证实的白色坏死婴儿。
We describe the neuropathologic and ultrasonographic findings in 22 very low birth weight infants (mean weight 948 gm) who survived at least 6 days and for whom cranial ultrasonography had been performed three or more times in life. White matter necrosis was found in 15 of the 22 subjects and was judged chronic (5 days'' duration or longer) in seven subjects. The most common pattern was diffuse necrosis of hemispheric white matter, found in 10 of 15 infants; restriction of necrosis to the periventricular region was found in only three infants. The classic histologic features of periventricular leukomalacia were absent from 7 of the 15 infants with necrosis. Seventeen infants had intraventricular hemorrhage, but extension of ventricular blood into white matter unaffected with white matter necrosis: increased parenchymal echogenicity and ventricular enlargement. One or both of these findings were present in 67% of infants with white matter necrosis, in 90% of infants with diffuse necrosis, but in no infant without necrosis. Increased parenchymal echogenicity was seen in all four infants with hemorrhagic necrosis. We conclude that the very small infants now dying in nurseries have a form of white matter damage that is more extensive than, and in some cases histologically different from, periventricular leukomalacia as originally described. Ultrasonography as used in this study identified most but not all infants with pathologically verified white matter necrosis.