Background Cerebellar haemorrhages (CBH) are increasingly recognised in extremely preterm infants with advances in early ultrasound neuroimaging. Information on incidences, risk factors, mortality and neurodevelopmental sequelae remains limited.
Aim To investigate the incidence of cerebellar haemorrhage in preterm infants diagnosed by ultrasound and identify risk factors and outcomes in a Tertiary Neonatal Intensive Care Unit.
Methods Preterm infants with cerebellar haemorrhage over 5 years (January 2009 to December 2013) were identified from a systematic electronic radiological database. Cases of cerebellar haemorrhage were diagnosed by cranial-ultrasound using the mastoid window and detailed medical record reviews were done.
Results A total of 13 cases were identified to have cerebellar haemorrhages (2641 infants <35 weeks were born during the study period). The gestation ranged from 23 to 28 weeks and birth weight ranged from 500 to 1940 grams. Isolated Cerebellar haemorrhages were seen in 4 cases (30%) with a preponderance of right sided haemorrhages (55%) and associated supra-tentorial lesions in 9 cases (70%). Analysis identified early postnatal haemodynamic risk factors. Neonatal mortality was significantly high amongst cases with combined cerebellar and supra-tentorial haemorrhage.
Conclusion In our study cerebellar haemorrhages is predominantly seen in the extreme preterm infants. It is associated with high mortality and predictors of risk factors appear to be multifactorial and include early postnatal haemodynamic factors. Early diagnosis and developmental follow-up help to identify infants with highest risk of developing long-term neurodevelopmental sequelae.
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