Leukocytosis in cerebrospinal fluid is unreliable as an indicator of meningitis in very preterm infants. In Cleveland, Ohio between 1977 and 1995 (

) 64 ill very low birthweight (<1.5 kg) infants had culture-positive cerebrospinal fluid samples. Of 38 samples not contaminated with blood only six contained >30 leukocytes/mm³ and all six were from babies with a gestational age of at least 33 weeks; none of 29 infants of lesser gestation had a CSF leukocytosis. Thirty-nine of 45 survivors were followed up to 20 months and, compared with 2053 very low birthweight controls, they had higher rates of major neurological abnormality (41% v 11%) and low (<70) Mental Development Index (38% v 14%).

Unilateral cerebellar lesions in young children may impair functional development in the opposite cerebral hemisphere. In Oxford (

) seven children who had had unilateral cerebellar tumours removed at a mean age of 3 years were assessed at a mean age of 7 years. The findings suggest that in right handed children damage to the right cerebellar hemisphere affects the development of verbal and literacy skills and damage to the left cerebellar hemisphere affects nonverbal or spatial skills. All children with cerebellar lesions should have long …