Neuropediatrics 2004; 35 - V32
DOI: 10.1055/s-2004-819374

Cerebellar atrophy in extreme premature infants

A Messerschmidt 1, PC Brugger 2, G Zoder 3, R Birnbacher 1, D Prayer 4
  • 1Department of Pediatrics, University of Vienna
  • 2Institute of Anatomy, University of Vienna
  • 3Children's Hospital Glanzing, Vienna
  • 4Department of Neuroradiology, University of Vienna, Austria

Objective: Supratentorial lesions are well known risks of extreme prematurity, while lesions of the cerebellum are rarely described. We report the delayed vanishing of the cerebellum in 21 of our patients with a birthweight less than 1500g.

Methods: Ultrasound scans were performed with an Acuson Devise 128 XP with a 7,5MHz-transducer. A 1,5 Tesla machine was used for MR-imaging in at least two planes with 3–5mm slice thickness.

Results: All patients developed intraventricular hemorrhages (IVH) of different degrees according to the classification of Papile. On ultrasound scans the cerebellum was initially normal, but subsequently became reduced in size and showed altered echogenicity in the first months of life. Two main types may be distinguished by MRI: white matter vanishing in the hemispheres with nearly intact vermis, and loss of the lower parts of both hemispheres and vermis with remarkably dilated 4th ventricle.

Conclusion: Extreme premature infants with IVH are at high risk to develop secondary cerebellar atrophy that has to be differentiated from congenital ponto-cerebellar atrophy.

Keywords: prematurity, cerebellar atrophy, intraventricular hemorrhage