Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Stein, M.
Cranial ultrasound analysis of the human corpus callosum: Regular development in premature and term infants and pathophysiological influence of periventricular echodensities and pericentricular leukomalacia
[ Dissertation ] Medical University of Graz; 2007. pp.
- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Resch Bernhard
- Ritschl Ewald
- Altmetrics:
- Abstract:
- Background and Purpose: The human corpus callosum (CC) is the largest fibre pathway of the brain connecting and integrating the function of both cortical hemispheres. There is preliminary evidence that its development is altered by white matter injury. Thus, the present thesis was aimed to, first, describe the normal growth of the cc by means of cranial sonography in healthy preterm and term infants in order to establish reference ranges for normal CC development. In a further approach, we investigated the impact of periventricular echodensities (PVE) and perventricular leukomalacia (PVL) on CC development is associated with an altered neurodevelopmental, clinical outcome in the first years of childhood. Materials and Methods: The study included 818 infants (493 preterm, 325 term patients) admitted to the neonatal intensive care unit at the University Hospital Graz from December 1997 to June 2006. Thickness and the length of the CC were determined weekly by means of cranial ultrasound starting in the first postnatal week until hospital discharge. The measurements of 582 children, who all fulfilled defined inclusion criteria, were used to assess the normal growth between the 23rd week of gestation and the 13th month postpartum. With respect to the white matter lesion study, 74 infants displayed a PVL and 77 infants showed a PVE as determined by cranial ultrasound. The respective control-group included 667 children, who neither showed PVL nor PVE. Clinical, neurodevelopmental assessment was performed for 717 infants using either the Bayley Scales of Infant Development or other clinical examinations. 101 children were lost to clinical follow-up. Results: With respect to the regular development of the human CC, thickness as well as length of the CC showed significant growth between the 23rd week of gestation and the 13th month. The increase in size was characterised by a low average growth rate (0,012mm/week and 0,1mm/month for CC thickness; 0,82mm/week and 0,80mm/month for CC length). There was no significant difference in CC development between males and females and no correlation of commissure growth with the increase in weight and circumference of the head. Importantly, children with PVL showed a significant smaller and shorter CC than controls. There was no significant difference in CC thickness for infants with PVE versus controls, however, infants of the PVE group displayed a significant shorter commissure. On the clinical level, we observed a significant accumulation of neurodevelopmental deficits in children with PVL than in controls.