Le Strange Elisabeth, Saeed Nadeem, Cowan Frances M, Edwards A David, Rutherford Mary A
Robert Steiner Magnetic Resonance Unit, Imaging Sciences Department, Imperial College, Hammersmith Campus, Du Cane Road, London W12 0HS, England, UK.
AJNR Am J Neuroradiol. 2004 Mar;25(3):463-8.
Cerebellar atrophy may occur as a result of a primary injury, such as infarction or hemorrhage. Impaired growth of a non-injured cerebellum may be seen as a secondary effect related to damage in other remote but connected areas of the brain, or so-called diaschisis. We sought to determine whether perinatal hypoxic-ischemic injury leads to poor cerebellar growth and whether such impairment occurs asymmetrically in infants with predominantly unilateral brain injury.
We used a computerized quantification program to measure cerebellar size by using serial MR images. Term-born infants presenting with encephalopathy and/or seizures presumed due to a hypoxic-ischemic insult within 48 hours of delivery were included if they had two or more volume acquisition images obtained at least 3 months apart but within the first 15 months of delivery.
When data were grouped by MR appearances, significant differences in total cerebellum growth were seen between infants with focal infarction and those with basal ganglia and thalamic injury (P <.001). Unilateral forebrain lesions shown on MR imaging were not predictive of asymmetric cerebellar growth.
Infants with focal infarction of the cerebral hemisphere had an apparently normal pattern of growth in both cerebellar hemispheres. However, in infants with severe basal ganglia and thalamic lesions, cerebellar growth was reduced, and the vermis showed little or no growth during the first year after birth.
小脑萎缩可能是由原发性损伤引起的，如梗死或出血。未受损伤的小脑生长受损可能被视为与大脑其他远处但相连区域的损伤相关的继发性效应，即所谓的交叉性小脑失联络。我们试图确定围产期缺氧缺血性损伤是否会导致小脑生长不良，以及这种损伤在主要为单侧脑损伤的婴儿中是否不对称发生。
我们使用计算机量化程序，通过连续磁共振成像测量小脑大小。如果足月出生的婴儿在出生后48小时内因缺氧缺血性损伤出现脑病和/或癫痫发作，且在出生后的前15个月内至少相隔3个月获得了两张或更多体积采集图像，则将其纳入研究。
当根据磁共振成像表现对数据进行分组时，局灶性梗死婴儿与基底神经节和丘脑损伤婴儿的小脑总体生长存在显著差异（P<.001）。磁共振成像显示的单侧前脑病变并不能预测小脑生长不对称。
大脑半球局灶性梗死的婴儿小脑两半球的生长模式明显正常。然而，在患有严重基底神经节和丘脑病变的婴儿中，小脑生长减缓，在出生后的第一年，蚓部几乎没有生长或没有生长。
