Pre-wallerian degeneration in the neonatal brain following perinatal cerebral hypoxia-ischemia demonstrated with MRI.

Full Abstract

AIM:
Pre-Wallerian degeneration was studied in term and near-term neonates with hypoxic-ischemic brain injury, and related to neurodevelopmental outcome.

SUBJECTS:
Thirty-nine surviving patients with hypoxic-ischemic encephalopathy or seizures and MRI-documented brain abnormalities were included. Patients were grouped according to the MRI findings:
group 1 (n = 23), ischemic stroke or watershed infarcts; group 2 (n = 8), lesions of the basal ganglia; group 3 (n = 8), predominantly white matter lesions.

METHODS:
Cranial MRI, including diffusion-weighted MRI, was performed between 1 and 10 days after birth. ADC maps were created, and presence or absence of pre-Wallerian degeneration in the cerebral peduncles was assessed.

RESULTS:
Of the 15 neonates with pre-Wallerian degeneration, 14 had permanent abnormalities of motor development, whereas 1 had a transient asymmetry. Six neonates with a poor outcome had no pre-Wallerian degeneration, which may be contributed to the timing of the MRI in 2. Eighteen neonates had no pre-Wallerian degeneration and a normal motor development.

CONCLUSION:
Pre-Wallerian degeneration of the cerebral peduncles in neonates with hypoxia-ischemia is almost invariably associated with a poor motor development. In neonates with abnormalities of the basal ganglia or white matter and a poor outcome, pre-Wallerian degeneration is less common than in neonates with stroke or watershed infarcts and a poor motor outcome.

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Author information

Author/s: Groenendaal, Floris (F); Benders, Manon J (MJ); de Vries, Linda S (LS);

Affiliation: Department of Neonatology, Division of Perinatology and Gynecology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Lundlaan 6, 3584 EA Utrecht, The Netherlands.

Journal and publication information

Publication Type: Journal Article

Journal: Seminars in perinatology (Semin Perinatol), published in United States. (Language: eng)

Reference: 2006-Jun; vol 30 (issue 3) : pp 146-50

Dates: Created 2006/07/03; Completed 2006/12/01;

PMID: 16813973, status: MEDLINE (last retrieval date: 12/26/2008)

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Diffusion Magnetic Resonance Imaging - methods
Humans
Hypoxia-Ischemia, Brain - complications; radiography
Infant, Newborn

Infant, Newborn
Infant, Premature - growth & development
Infant, Premature, Diseases - radiography
Wallerian Degeneration - etiology; radiography

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