Preterm neuroimaging and neurodevelopmental outcome: a focus on intraventricular hemorrhage, post-hemorrhagic hydrocephalus, and associated brain injury

Abstract

Intraventricular hemorrhage in the setting of prematurity remains the most common cause of acquired hydrocephalus. Neonates with progressive post-hemorrhagic hydrocephalus are at risk for adverse neurodevelopmental outcomes. The goal of this review is to describe the distinct and often overlapping types of brain injury in the preterm neonate, with a focus on neonatal hydrocephalus, and to connect injury on imaging to neurodevelopmental outcome risk. Head ultrasound and magnetic resonance imaging findings are described separately. The current state of the literature is imprecise and we end the review with recommendations for future radiologic and neurodevelopmental research.

Fig. 1

Head ultrasound ventricular size measurements

Fig. 2

T2-weighted MR images of premature infant with post­hemorrhagic hydrocephalus. There is marked enlargement of all four ventricles. The sagittal image shows marked compression of the cerebellum secondary to fourth ventricular dilatation. The axial and coronal images show thinning of the cerebral mantle and fenestration of the septum pellucidum due to marked dilatation of the lateral ventricles