Tam Emily W Y
Division of Neurology, Department of Paediatrics, Hospital for Sick Children, University of Toronto, Toronto, Canada.
Handb Clin Neurol. 2018;155:49-59. doi: 10.1016/B978-0-444-64189-2.00003-2.
Although preterm birth is best known to result in adverse neurodevelopmental outcomes through injury of the supratentorial structures, including intraventricular hemorrhage and periventricular leukomalacia, the cerebellum has become increasingly recognized as an important target for injury and adverse motor and cognitive outcomes. Undergoing the most dramatic growth during the preterm period, the cerebellum is vulnerable to large and small hemorrhages, as well as hypoplasia resulting from a number of potentially modifiable risk factors. These factors include contact with intraventricular blood, crossed cerebrocerebellar diaschisis, postnatal glucocorticoid exposure, pain and opioid exposure, nutrition and somatic growth, cardiorespiratory factors, and socioeconomic status. Strategies targeting these factors may result in prevention of the motor and cognitive deficits seen after cerebellar hemorrhage or hypoplasia.
虽然早产最广为人知的是通过幕上结构损伤导致不良神经发育结局,包括脑室内出血和脑室周围白质软化,但小脑越来越被认为是损伤以及运动和认知不良结局的重要靶点。小脑在早产期间经历最显著的生长,易发生大小出血以及由一些潜在可改变的风险因素导致的发育不全。这些因素包括接触脑室内血液、交叉性小脑大脑失联络、出生后糖皮质激素暴露、疼痛和阿片类药物暴露、营养和躯体生长、心肺因素以及社会经济地位。针对这些因素的策略可能会预防小脑出血或发育不全后出现的运动和认知缺陷。