NATURAL-HISTORY OF VENTRICULAR DILATATION IN PRETERM INFANTS - PROGNOSTIC-SIGNIFICANCE

Cerebral ultrasounds were prospectively performed in 100 infants weigh ing 1,500 gm or less in order to evaluate the prognostic significance of ventricular dilatations and their associated findings. There was no difference in the incidence of ventricular dilatation (24%) between p atients with or without periventricular hemorrhage (PVH). Although pat ients with PVH developed ventricular dilatation significantly earlier than infants without PVH, no differences were observed in severity, lo cation, head circumference growth, or intracranial pressure between th e groups. Ventricular dilatation was statistically related to PVH grad e III and PVH with parenchymal involvement; grades moderate-to-severe of periventricular echogenicity; and cystic periventricular leukomalac ia (PVL). Ventricular dilatation persisted longer than 6 weeks in 61% of infants and had irregular margins in 62%. The latter were significa ntly related to cystic PVL. Seventy-seven of 100 infants examined were followed until 20 months corrected age. Ventricular dilatation mainly when persistent and with irregular margins was associated with handic aps. We conclude that ventricular dilatation is frequent in very low-b irth weight infants. Furthermore, its occurrence may be independent of PVH. Persistent ventricular dilatation with irregular margins, even i n its mild forms, suggests a parenchymal lesion and guarded prognosis.