Cerebellar injury in preterm children with cerebral palsy after intraventricular hemorrhage: Prevalence and relationship to functional outcomes
Cerebellar injury in preterm children with cerebral palsy after intraventricular hemorrhage: Prevalence and relationship to functional outcomes
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DOI：
10.1016/j.braindev.2014.12.009
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发表时间：
2015-09-01
影响因子：
1.7
通讯作者：
Arai, Hiroshi
中科院分区：
文献类型：
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作者：
Kitai, Yukihiro;Hirai, Satori;Arai, Hiroshi
目的：阐明脑室内出血 (IVH) 后脑瘫 (CP) 早产儿小脑损伤的患病率及其与功能结局的关系。 参与者：我们从 2049 名就诊于西日本 CP 区域中心医院森之宫医院的脑瘫儿童中选择了 69 名儿童（40 名男性和 29 名女性，年龄在 6 至 13 岁之间）。纳入标准为（1）出生时胎龄小于36周，（2）有明确的产后脑室内出血病史，（3）调查时年龄超过6岁。排除未进行充分影像学研究或功能评估的患者。方法：根据是否存在出血后脑积水（PH）和小脑损伤（CI）将参与者分为四组：PH+/CI+、PH+/CI-、PH-/CI+和PH-/CI-。调查并比较各组间CP类型、行走能力、言语功能、严重视力障碍发生率以及癫痫并发症。结果：参与者的胎龄在22至34周之间，出生体重在412至1788 g之间。 PH 和 CI 分别见于 39 名 (57%) 和 40 名 (58%) 儿童。 PH+/CI+组（n = 31）和PH-/CI+组（n = 9）的步行和言语能力均显着低于PH-/CI-组（n = 21），而癫痫发生率则高于PH-/CI-组（n = 21），而PH+/CI-组与PH-/CI-组没有显着差异。仅在PH+/CI+组和PH-/CI+组中发现严重视力障碍。结论：IVH后CP的早产儿CI发生率（58%）与PH几乎相同。 CI 是早产儿最重要的并发症之一，影响运动和语言功能，并且与癫痫的相关性高于 PH。 (C) 2014 年日本儿童神经病学学会。由 Elsevier B.V. 出版。保留所有权利。
Objectives: To elucidate the prevalence of cerebellar injury and its relationship to functional outcomes in preterm children with cerebral palsy (CP) after intraventricular hemorrhage (IVH).Participants: We selected 69 children (40 males and 29 females, aged between 6 and 13 years) out of 2049 with cerebral palsy who visited Morinomiya Hospital, the regional center hospital for CP in West Japan. The inclusion criteria were (1) gestational age under 36 weeks at birth, (2) clear history of postnatal intraventricular hemorrhage, and (3) age at investigation over 6 years old. Those without sufficient imaging study or functional evaluation were excluded.Methods: The participants were divided into four groups according to the presence of post-hemorrhagic hydrocephalus (PH) and cerebellar injury (CI): PH+/CI+, PH+/CI-, PH-/CI+, and PH-/CI-. Type of CP, ability to walk, verbal function, the incidence of severe visual impairment, and the complication of epilepsy were investigated and compared among the groups.Results: The gestational ages of the participants were between 22 and 34 weeks, and their birth weight was between 412 and 1788 g. PH and CI were found in 39 (57%) and 40 (58%) children, respectively. Both the PH+/CI+ group (n = 31) and the PH-/CI+ group (n = 9) showed significantly lower walking and verbal abilities and a higher incidence of epilepsy than the PH-/CI- group (n = 21), while the PH+/CI- group showed no significant difference from the PH-/CI- group. Severe visual impairment was found only in the PH+/CI+ group and the PH-/CI+ group.Conclusions: The prevalence of CI in preterm children with CP after IVH (58%) was almost the same as that of PH. CI is one of the most significant complications in preterm infants, affecting motor and verbal functions and being associated with epilepsy more than PH. (C) 2014 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved.