Can Obstetricians Prevent Neonatal Intraventricular Haemorrhage?

The possible influence of obstetric and early neonatal factors on the development of neonatal intraventricular haemorrhage (IVH) in very low birth-weight infants have been studied. Caesarean section was associated with a significantly lower incidence of IVH, this reduction being largely confined to infants of 25-28 weeks' gestation. Forceps delivery did not seem to influence the rate of occurrence of IVH if one allowed for differences in gestational age between infants delivered spontaneously and those with forceps. Similarly the use of an episiotomy at the time of delivery did not seem to reduce the incidence of IVH, and a similar lack of correlation was found with the other factors examined.     

Intracranial lesions of congenital cytomegalovirus infection detected by ultrasound scanning

Four cases of congenital cytomegalovirus infection associated with previously unreported intracranial lesions--paraventricular cysts and intraventricular strands and mild ventriculomegaly--are described. These findings may have serious implications regarding the long-term neurologic prognosis for infants with congenital cytomegalovirus infection.     

Multilocal magnetic resonance perfusion mapping comparing the cerebral hemodynamic effects of decompressive craniectomy versus reperfusion in experimental acute hemispheric stroke in rats

This study examined the hemodynamic effects of craniectomy compared to reperfusion on the temporal evolution of cerebral perfusion in different brain regions in a rat model of focal cerebral ischemia. Three groups were investigated: no treatment, reperfusion or craniectomy at 1 h. Perfusion-weighted magnetic resonance imaging (PWI) was performed serially from 0.5 to 6 h. Relative regional cerebral blood flow was calculated for different regions and infarct volume was assessed by histology at 24 h. As conclusion, both, craniectomy and reperfusion increased cerebral perfusion in the acute phase of cerebral ischemia. While reperfusion resulted in a homogeneous improvement of perfusion in the cortex and basal ganglia, craniectomy improved only cortical perfusion in areas directly under the craniectomy site. PWI is well suited to non-invasively monitor perfusion alterations after aggressive therapeutical approaches in stroke.     

Ventricular size in newborn infants

Cranial ultrasound examinations were performed on 533 infants of between 48 and 96 hours of age to establish the range of ventricular size in neonates of different gestational ages in whom there was no evidence of intraventricular hemorrhage or neural tube defects. It was found that ventricular size did not vary in infants with gestational age of 26 weeks or more. Only 15 (2.8 per cent) neonates had a ventricular width of greater than 3 mm. Of these 15 infants, 13 were re-examined within the first year of life and found to be neurologically and developmentally normal.     

The effects of brain tissue decomposition on diffusion tensor imaging and tractography

There have been numerous high resolution diffusion tensor imaging studies in fixed animal brains, but relatively few studies in human brains. While animal tissues are generally fixed pre-mortem or directly postmortem, this is not possible for human tissue, therefore there is always some delay between death and tissue fixation. The elapsed time between death and tissue fixation, the postmortem interval (PMI), will most likely adversely affect the tissue's diffusion properties. We studied the effects of PMI on the diffusion properties of rodent brain. Eight mice were euthanized and the brains (kept in the skull) were placed in formalin at PMIs of 0, 1, 4 and 14 days. Post fixation they were placed in a solution of GdDTPA and phosphate buffered saline. Brains were scanned with a 3D EPI DTI sequence at 4.7T. DTI data were processed to generate apparent diffusion coefficient (ADC) and fractional anisotropy (FA) maps. DTI tractography was also performed. The temporal changes in regional ADC and FA values were analyzed statistically using a one-way ANOVA, followed by individual Student's T-tests. Regional FA and ADC of gray and white matter decreased significantly with time (p<0.05). DTI tractography showed a decrease in the number and coherence of reconstructed fiber pathways between PMIs 0 and 14. Elapsed time between death and tissue fixation has a major effect upon the brain's diffusion properties and should be born in mind when interpreting fixed brain DTI.