Cerebellar Hemorrhagic Injury In Premature Infants Occurs During A Vulnerable Developmental Period And Is Associated With Wider Neuropathology
Cerebellar hemorrhagic injury (CHI) is being recognized more frequently in premature infants. However, much of what we know about CHI neuropathology is from autopsy studies that date back to a prior era of neonatal intensive care. To update and expand our knowledge of CHI we reviewed autopsy materials and medical records of all live-born preterm infants (<37 weeks gestation) autopsied at our institution from 1999-2010 who had destructive hemorrhagic injury to cerebellar parenchyma (n = 19) and compared them to matched non-CHI controls (n = 26). We favor the possibility that CHI represents a primary hemorrhage arising due to the effects of impaired autoregulation in a delicate vascular bed. The incidences of neuronal loss and gliosis in the inferior olivary and dentate nuclei, critical cerebellar input and output structures, respectively were higher in CHI compared to control cases and may represent a transsynpatic degenerative process. CHI occurs during a critical developmental period and may render the cerebellum vulnerable to additional deficits if cerebellar growth and neuronal connectivity are not established as expected. Therefore, CHI has the potential to significantly impact neurodevelopmental outcome in survivors.
I am writing this book for children because the day when my parents became ministers I felt power and glory and blood I never knew I had. GOD is our father and we, His children, should respect Him with all our heart and soul. Estoy escribiendo esta pagina para los ninos, porque el dia en que mis padres se convirtieron en ministros, senti poder y gloria y sangre que no sabia que tenia. DIOS es nuestro Padre y nosotros sus hijos, debemos respetarlo con todo nuestro corazon y toda nuestra alma."
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