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Neurological in premature infants Problems and Watch

Yıl 2017, Cilt: 9 Sayı: 4, 45 - 49, 20.07.2017

Öz

Abstract

Neurodevelopmental disabilities continue to be a leading cause of morbidity insurvivors of premature birth. Although improved neonatal intensive care has reduced the mortality of preterm neonates, many preterm survivors continue to have major motor deficits, including cerebral palsy and significant cognitive, behavioral orsensory deficits.Germinal matrixintraventricular hemorrhage and white matter injury are common patterns of brain injury in premature newborns.  Whereas preterm infants werepreviously at high risk for destructive white and gray matter degeneration, now lesssevere injury that does not appear to involve pronounced glial or neuronal loss is com-mon. These milder forms of injury are associated with reduced cerebral growth. Recent studies support that this impaired cerebral growth involves abnormal maturation of neurons and glia rather than cell death. These recently recognized forms ofcerebral gray and white matter dysmaturation raise new diagnostic challenges andmay suggest new therapeutic directions in future.

Kaynakça

  • Kaynaklar 1.Anderson PJ. Neurophysiological outcomes of children bornvery preterm. Semin Fetal Neonatal Med 2014;19:90-96. 2.Hamrick SE, Miller SP, Leonard C, Glidden DV, GoldsteinR, Ramaswamy V, et al. Trends in severe brain injury and neu-rodevelopmental outcome in premature newborn infants: therole of cystic periventricular leukomalacia. J Pediatr 2004;145(5):593–599. 3.Groenendaal F, Termote JU, van der Heide-Jalving M, vanHaastert IC, de Vries LS. Complications affecting preterm neo-nates from 1991 to 2006: what have we gained? Acta Paedi-atr 2010; 99(3):354–358. 4.Back SA. Brain Injury in the Preterm Infant: New Horizonsfor Pathogenesis and Prevention. Pediatr Neurol 2015;53(3): 185–192. 5.Stoll BJ, Hansen NI, Bell EF, et al; Eunice Kennedy ShriverNational Institute of Child Health and Human DevelopmentNeonatal Research Network. Neonatal outcomes of extremelypreterm infants from the NICHD Neonatal Research Network.Pediatrics 2010;126(3):443–456. 6.Papile LA, Burstein J, Burstein R, Koffler H. Incidence andevolution of subependymal and intraventricular hemorrhage:a study of infants with birth weights less than 1,500 gm. J Pe-diatr 1978; 92(4): 529-34. 7.Volpe JJ. Brain injury in premature infants: a complexamalgam of destructive and develoopmental disturbances. Lan-cet Neurol 2009;8:110-124. 8.Payne AH, Hintz SR, Hibbs AM, et al. Neurodevelopmentaloutcomes of extremely low-gestational-age neonates with low-grade periventricular-intraventricular hemorrhage. JAMA Pe-diatr 2013; 167:451. 9.Mukerji A, Shah V, Shah PS. Periventricular/Intraventricu-lar Hemorrhage and Neurodevelopmental Outcomes: AMeta-analysis. Pediatrics 2015; 136(6): 1132-1143. 10.Schafer RJ, Lacadie C, Vohr B, et al. Alterations in functio-nal connectivity for language in prematurely born adolescents.Brain 2009; 132(3):661–670. 11.Gallo V, Deneen B. Glial development: the crossroads of re-generation and repair in the CNS. Neuron 2014;83(2):283–308. 12.Buser J, Maire J, Riddle A, et al. Arrested pre-oligodendrocy-te maturation contributes to myelination failure in prematu-re infants. Ann Neurol 2012; 71(1):93–109. 13.Smyser CD, Inder TE, Shimony JS, et al. Longitudinal Analy-sis of Neural Network Development in Preterm Infants. Ce-reb Cortex 2010;20:2852–2862. 14.Dean J, McClendon E, Hansen K, et al. Prenatal cerebral isc-hemia disrupts MRI-defined cortical microstructure throughdisturbances in neuronal arborization. Sci Transl Med.2013; 5(166-170): 101–111. 15.Volpe JJ Systemic inflammation, oligodendroglial maturati-on, and the encephalopathy of prematurity. Ann Neurol. 2011Oct;70(4):525-9 16.O'Shea TM, Kuban KC, Allred EN, et al. Neonatal cranial ult-rasound lesions and developmental delays at 2 years of ageamong extremely low gestational age children. Pediatrics 2008;122:e662. 17.de Vries LS, Benders MNL, Groenendaal F. Progress in Neo-natal Neurology with a Focus on Neuroimaging in the Pre-term Infant. Neuropediatrics 2015;46:234–241. 18.Woodward LJ, Anderson PJ, Austin NC, et al. Neonatal MRIto predict neurodevelopmental outcomes in preterm infants.N Engl J Med 2006; 355:685. 19.Hintz SR, Barnes PD, Bulas D, et al. Neuroimaging and neu-rodevelopmental outcome in extremely preterm infants. Pe-diatrics 2015; 135:e32. 20.Ment LR, Vohr B, Allan W, et al. Change in cognitive functi-on over time in very low-birth-weight infants. JAMA 2003;289:705. 21.Marlow N, Wolke D, Bracewell MA, Samara M. Neurologicand developmental disability at six years of age after extre-mely preterm birth. N Engl J Med 2005; 352:9-19.

Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi

Yıl 2017, Cilt: 9 Sayı: 4, 45 - 49, 20.07.2017

Öz

Öz

Nörogelişimsel sekeller prematüre bebeklerde görülen uzun dönem morbiditelerin en önemlisidir. Yenidoğan yoğun bakımındaki ilerlemelere bağlı olarak prematüre bebeklerin mortalitesi giderek azalmakta ancak serebral palsi gibi ağır motor sekeller ve belirgin bilişsel, davranışsal ve duyusal bozukluklar gibi ciddi nörogelişimsel bozukluklar görülmeye devam etmektedir. Germinal matriks kanaması-İntraventriküler kanama (GMK-İVK) ve beyaz cevher hasarı, prematüre bebeklerde sık görülen ve beyin hasarının en önemli nedenlerini oluşturan nörolojik komplikasyonlardır. Prematüre bebeklerde son yıllarda ağır destrüktif beyin hasarından çoke nöronal ve glial hücre ölümüne yol açmayan daha hafif beyin hasarının olduğu, bununbeyin büyümesini olumsuz etkilediği, bozulmuş beyin büyümesinin hücre ölümünden ziyade nöron ve glial hücrelerin anormal maturasyonu ile ilişkili olabileceği gösterilmiştir. Serebral gri ve beyaz cevher dismaturasyonunun daha iyi anlaşılmasıyla gelecekte engellenmesi ve uzun dönem nörolojik prognozun düzeltilmesi ile ilgili yeni yaklaşımlar gündeme gelebilecektir.

Kaynakça

  • Kaynaklar 1.Anderson PJ. Neurophysiological outcomes of children bornvery preterm. Semin Fetal Neonatal Med 2014;19:90-96. 2.Hamrick SE, Miller SP, Leonard C, Glidden DV, GoldsteinR, Ramaswamy V, et al. Trends in severe brain injury and neu-rodevelopmental outcome in premature newborn infants: therole of cystic periventricular leukomalacia. J Pediatr 2004;145(5):593–599. 3.Groenendaal F, Termote JU, van der Heide-Jalving M, vanHaastert IC, de Vries LS. Complications affecting preterm neo-nates from 1991 to 2006: what have we gained? Acta Paedi-atr 2010; 99(3):354–358. 4.Back SA. Brain Injury in the Preterm Infant: New Horizonsfor Pathogenesis and Prevention. Pediatr Neurol 2015;53(3): 185–192. 5.Stoll BJ, Hansen NI, Bell EF, et al; Eunice Kennedy ShriverNational Institute of Child Health and Human DevelopmentNeonatal Research Network. Neonatal outcomes of extremelypreterm infants from the NICHD Neonatal Research Network.Pediatrics 2010;126(3):443–456. 6.Papile LA, Burstein J, Burstein R, Koffler H. Incidence andevolution of subependymal and intraventricular hemorrhage:a study of infants with birth weights less than 1,500 gm. J Pe-diatr 1978; 92(4): 529-34. 7.Volpe JJ. Brain injury in premature infants: a complexamalgam of destructive and develoopmental disturbances. Lan-cet Neurol 2009;8:110-124. 8.Payne AH, Hintz SR, Hibbs AM, et al. Neurodevelopmentaloutcomes of extremely low-gestational-age neonates with low-grade periventricular-intraventricular hemorrhage. JAMA Pe-diatr 2013; 167:451. 9.Mukerji A, Shah V, Shah PS. Periventricular/Intraventricu-lar Hemorrhage and Neurodevelopmental Outcomes: AMeta-analysis. Pediatrics 2015; 136(6): 1132-1143. 10.Schafer RJ, Lacadie C, Vohr B, et al. Alterations in functio-nal connectivity for language in prematurely born adolescents.Brain 2009; 132(3):661–670. 11.Gallo V, Deneen B. Glial development: the crossroads of re-generation and repair in the CNS. Neuron 2014;83(2):283–308. 12.Buser J, Maire J, Riddle A, et al. Arrested pre-oligodendrocy-te maturation contributes to myelination failure in prematu-re infants. Ann Neurol 2012; 71(1):93–109. 13.Smyser CD, Inder TE, Shimony JS, et al. Longitudinal Analy-sis of Neural Network Development in Preterm Infants. Ce-reb Cortex 2010;20:2852–2862. 14.Dean J, McClendon E, Hansen K, et al. Prenatal cerebral isc-hemia disrupts MRI-defined cortical microstructure throughdisturbances in neuronal arborization. Sci Transl Med.2013; 5(166-170): 101–111. 15.Volpe JJ Systemic inflammation, oligodendroglial maturati-on, and the encephalopathy of prematurity. Ann Neurol. 2011Oct;70(4):525-9 16.O'Shea TM, Kuban KC, Allred EN, et al. Neonatal cranial ult-rasound lesions and developmental delays at 2 years of ageamong extremely low gestational age children. Pediatrics 2008;122:e662. 17.de Vries LS, Benders MNL, Groenendaal F. Progress in Neo-natal Neurology with a Focus on Neuroimaging in the Pre-term Infant. Neuropediatrics 2015;46:234–241. 18.Woodward LJ, Anderson PJ, Austin NC, et al. Neonatal MRIto predict neurodevelopmental outcomes in preterm infants.N Engl J Med 2006; 355:685. 19.Hintz SR, Barnes PD, Bulas D, et al. Neuroimaging and neu-rodevelopmental outcome in extremely preterm infants. Pe-diatrics 2015; 135:e32. 20.Ment LR, Vohr B, Allan W, et al. Change in cognitive functi-on over time in very low-birth-weight infants. JAMA 2003;289:705. 21.Marlow N, Wolke D, Bracewell MA, Samara M. Neurologicand developmental disability at six years of age after extre-mely preterm birth. N Engl J Med 2005; 352:9-19.
Toplam 1 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm makale
Yazarlar

Prof. Dr. E.esra Önal Bu kişi benim

Yayımlanma Tarihi 20 Temmuz 2017
Yayımlandığı Sayı Yıl 2017 Cilt: 9 Sayı: 4

Kaynak Göster

APA Önal, P. D. E. (2017). Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi. Klinik Tıp Pediatri Dergisi, 9(4), 45-49.
AMA Önal PDE. Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi. Pediatri. Temmuz 2017;9(4):45-49.
Chicago Önal, Prof. Dr. E.esra. “Prematüre Bebeklerde Nörolojik Sorunlar Ve İzlemi”. Klinik Tıp Pediatri Dergisi 9, sy. 4 (Temmuz 2017): 45-49.
EndNote Önal PDE (01 Temmuz 2017) Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi. Klinik Tıp Pediatri Dergisi 9 4 45–49.
IEEE P. D. E. Önal, “Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi”, Pediatri, c. 9, sy. 4, ss. 45–49, 2017.
ISNAD Önal, Prof. Dr. E.esra. “Prematüre Bebeklerde Nörolojik Sorunlar Ve İzlemi”. Klinik Tıp Pediatri Dergisi 9/4 (Temmuz 2017), 45-49.
JAMA Önal PDE. Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi. Pediatri. 2017;9:45–49.
MLA Önal, Prof. Dr. E.esra. “Prematüre Bebeklerde Nörolojik Sorunlar Ve İzlemi”. Klinik Tıp Pediatri Dergisi, c. 9, sy. 4, 2017, ss. 45-49.
Vancouver Önal PDE. Prematüre Bebeklerde Nörolojik Sorunlar ve İzlemi. Pediatri. 2017;9(4):45-9.