The neonatal cerebellum

Abstract

Newborn infants requiring intensive care treatment are at risk of cerebellar injury. This can have important consequences for long-term neurodevelopmental outcome. The aim of this thesis was to study the incidence and characteristics of cerebellar injury, and to investigate the role of different neuroimaging techniques (cranial ultrasound (CUS) with additional mastoid fontanelle (MF) views and MRI) for its detection in both preterm and high-risk term infants. Part I describes the standard CUS procedure and supplementary imaging techniques to optimize its performance, including the use of additional acoustic windows. Part II focuses on the detection, risk factors and prognostic implications of cerebellar injury in preterm infants. Part III focuses on CUS and MRI findings of posterior fossa abnormalities in full-term infants with various neonatal disorders. Part VI reviews the main findings and conclusions of this thesis, and discusses future perspectives and proposals for further research. Based on the findings of this thesis, we conclude that in both preterm and critically ill full-term infants CUS protocols should include MF views. This enables early detection of most major and clinically relevant posterior fossa abnormalities. Routine MRI for the detection of small hemorrhagic lesions is not warranted, as these lesions have a favorable prognosis