Cranial ultrasound lesions in the NICU predict cerebral palsy at age 2 years in children born at extremely low gestational age

Karl C K Kuban, Elizabeth N. Allred, Michael T. O'Shea, Nigel Paneth, Marcello Pagano, Olaf Dammann, Alan Leviton, Adré Du Plessis, Sjirk J. Westra, Cindy R. Miller, Haim Bassan, Kalpathy Krishnamoorthy, Joseph Junewick, Nicholas Olomu, Elaine Romano, Joanna Seibert, Steve Engelke, Padmani Karna, Daniel Batton, Sunila E. O'ConnorCecelia E. Keller

Research output: Contribution to journalArticlepeer-review

83 Scopus citations

Abstract

Our prospective cohort study of extremely low gestational age newborns evaluated the association of neonatal head ultrasound abnormalities with cerebral palsy at age 2 years. Cranial ultrasounds in 1053 infants were read with respect to intraventricular hemorrhage, ventriculomegaly, and echolucency, by multiple sonologists. Standardized neurological examinations classified cerebral palsy, and functional impairment was assessed. Forty-four percent with ventriculomegaly and 52% with echolucency developed cerebral palsy. Compared with no ultrasound abnormalities, children with echolucency were 24 times more likely to have quadriparesis and 29 times more likely to have hemiparesis. Children with ventriculomegaly were 17 times more likely to have quadriparesis or hemiparesis. Forty-three percent of children with cerebral palsy had normal head ultrasound. Focal white matter damage (echolucency) and diffuse damage (late ventriculomegaly) are associated with a high probability of cerebral palsy, especially quadriparesis. Nearly half the cerebral palsy identified at 2 years is not preceded by a neonatal brain ultrasound abnormality.

Original languageEnglish (US)
Pages (from-to)63-72
Number of pages10
JournalJournal of child neurology
Volume24
Issue number1
DOIs
StatePublished - Feb 9 2009

Keywords

  • Cerebral palsy
  • Cranial ultrasound
  • Extremely low gestational age

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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