CORRELATION BETWEEN NEONATAL CRANIAL ULTRASOUND, MRI IN INFANCY AND NEURODEVELOPMENTAL OUTCOME IN INFANTS WITH A LARGE INTRAVENTRICULAR HEMORRHAGE WITH OR WITHOUT UNILATERAL PARENCHYMAL INVOLVEMENT

During a 7-year-period, 1625 infants of 34 weeks gestation or less wer e enrolled in a prospective ultrasound (US) study. One hundred and ele ven (6.8 %) infants developed a large intraventricular haemorrhage (IV H) with or without unilateral parenchymal involvement (PI). Fifty-six of these 111 infants survived (50.4 %) and in 23 (41 %) of them a magn etic resonance imaging (MRI) study was performed beyond 12 months corr ected age. There appeared to be a good agreement between neonatal ultr asound findings and MRI changes noted in infancy. Of the 10 cases with a large IVH without PI (group A), seven had a VP shunt with complete decompression of previously enlarged ventricles. Six of these seven in fants had periventricular hyperintensity (PVHI) but none developed cer ebral palsy (CP). Two of the ten cases without a VP shunt had irregula r ventricular enlargement (VE) with PVHI in one. Both developed CP Sev en cases showed thinning of the corpus callosum. Of the 13 cases with a large IVH associated with PI (group B), the site of the PI could sti ll be recognised on MRI and the degree of communication of the porence phalic cyst (PC) with the lateral ventricles correlated well with neon atal US findings. On MRI, VE was present in only 6 cases. Wallerian de generation was present in 9/13 infants and all but one developed a hem iplegia. In 12113 cases there was thinning of the corpus callosum, eit her focal or diffuse. PVHI was present in all infants. In 6/13 PVHI wa s only present around the PC. Neurodevelopmental outcome differed for both groups. CP was only present in 2/10 infants in group A, compared to 11/13 in group B. Global delay, in the absence of CP, was more comm on in infants with a large IVH than in those with associated PI. Concl usion Combining neonatal US with MRI in infancy enhances our understan ding of the long-term effects of severe haemorrhagic brain lesions, oc curring in preterm infants.