Document Detail


Periventricular leukomalacia with late-onset circulatory dysfunction of premature infants: correlation with severity of magnetic resonance imaging findings and neurological outcomes.
MedLine Citation:
PMID:  17146199     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence of late-onset circulatory dysfunction (LCD) of premature infants, which is characterized by sudden hypotension and oliguria, has recently increased in Japan. This condition suddenly occurs after several days of age without obvious causes in preterm infants with stable respiration and circulation. Intravenous steroids frequently improve the hypotension. The main problem with LCD is the subsequent and frequent onset of periventricular leukomalacia (PVL), and neurological development appears to be worse in PVL patients with LCD than those without LCD. The aim of this study was to determine whether the severity of magnetic resonance imaging (MRI) findings and neurological outcomes differ between infants who developed PVL after LCD and those who developed PVL without LCD. We retrospectively studied preterm infants who were delivered at less than 33 weeks of gestation between the years 2000 and 2003. During the study period, 10 and 26 infants developed PVL with and without LCD, respectively. The incidence of severe or moderate MRI findings was significantly higher in PVL patients with LCD (100%) than those without LCD (50%; p < 0.05). The incidence of severe cerebral palsy was 88% in PVL infants with LCD and 43% in PVL infants without LCD (p < 0.05). Moreover, the incidence of visual disorders was significantly higher in PVL infants with LCD (63%) than those without LCD (9%; p < 0.01). In conclusion, neurological outcomes are worse in preterm infants who develop PVL with LCD than those without LCD, which is well correlated to the severity judged by MRI findings.
Authors:
Satoru Kobayashi; Shinji Fujimoto; Sumio Fukuda; Ayako Hattori; Toshimitsu Iwaki; Norihisa Koyama; Taihei Tanaka; Minoru Kokubo; Tohru Okanishi; Hajime Togari
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  The Tohoku journal of experimental medicine     Volume:  210     ISSN:  0040-8727     ISO Abbreviation:  Tohoku J. Exp. Med.     Publication Date:  2006 Dec 
Date Detail:
Created Date:  2006-12-05     Completed Date:  2007-01-09     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0417355     Medline TA:  Tohoku J Exp Med     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  333-9     Citation Subset:  IM    
Affiliation:
Department of Pediatrics, Neonatology and Congenital Disorders, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan. skoba@med.nagoya-cu.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Blood Circulation / physiology*
Cerebral Palsy / etiology*
Disease Progression
Epilepsy / etiology
Female
Gestational Age
Hearing Loss / etiology
Humans
Hypotension / complications
Hypoxia-Ischemia, Brain / complications*
Incidence
Infant, Low Birth Weight
Infant, Newborn
Infant, Premature / physiology*
Leukomalacia, Periventricular / complications*,  pathology,  ultrasonography
Magnetic Resonance Imaging*
Male
Oliguria / complications
Retrospective Studies
Severity of Illness Index
Time Factors
Vascular Diseases / complications
Vision Disorders / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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