Objective Cerebellar hemorrhages (CH) in the neonatal period have only been described within the past 10 years. We report on the neurologic and cognitive outcomes of 22 patients with CH and examine the value of ultrasonography or MRI in this situation.
Methods The UCSF ICN Follow Up database identified 26 babies born between 1993 and 2003 who had CH. Twenty-two subject-control pairs were identified. Controls were similar in birth weight (cont 858 ± 231, CH 899 ± 273) and gestational age (cont 26.1 ± 2, CH 26.0 ± 2). All had sonograms, and 17 subjects had MRI. Severity of IVH, neurologic outcome, and cognitive outcome were recorded at the latest visit in common (cont 27 ± 21 mo, range 3-97; CH 28 ± 21 mo, range 6-97).
Results See Table.
In paired analysis, neurologic outcomes were equal for 13. In six cases the CH had a worse outcome (four of these had worse IVH in the CH patient). Cognitive outcomes were equal in nine pairs; the CH babies had worse outcomes in six (three with worse IVH in the CH patient). In seven cases the CH had better cognitive outcomes. All CH patients with abnormal outcomes had a CH detected by ultrasonography. Positive predictive value of ultrasonography for any non-normal outcome was 73% and for MRI 44%. Eight babies had CH but no IVH. None of these were neurologically abnormal and one was cognitively abnormal. Among the eight controls who had no IVH (not matched) one was neurologically abnormal and two were cognitively abnormal.
Conclusion CHs have an unclear impact on neurologic and cognitive outcomes. Some early findings may reflect prematurity rather than the effect of CH on outcome. Overall outcomes were similar in our CH and control groups. CH on MRI has lower predictive value than ultrasonographyd. Further investigation and longer-term follow-up are warranted.
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