Hong Juntaek, Rha Dong-Wook
Department and Research Institute of Rehabilitation Medicine, Yonsei University College of Medicine, Seoul, Korea.
J Korean Neurosurg Soc. 2023 May;66(3):289-297. doi: 10.3340/jkns.2022.0262. Epub 2023 Feb 8.
Technological advances in neonatology led to the improvement of the survival rate in preterm babies with very low birth weights. However, intraventricular hemorrhage (IVH) has been one of the major complications of prematurity. IVH is relevant to neurodevelopmental disorders, such as cerebral palsy, language and cognitive impairments, and neurosensory and psychiatric problems, especially when combined with brain parenchymal injuries. Additionally, severe IVH requiring shunt insertion is associated with a higher risk of adverse neurodevelopmental outcomes. Multidisciplinary and longitudinal rehabilitation should be provided for these children based on the patients' life cycles. During the infantile period, it is essential to detect high-risk infants based on neuromotor examinations and provide early intervention as soon as possible. As babies grow up, close monitoring of language and cognitive development is needed. Moreover, providing continuous rehabilitation with task-specific and intensive repetitive training could improve functional outcomes in children with mild-to-moderate disabilities. After school age, maintaining the level of physical activity and managing complications are also needed.
新生儿学的技术进步提高了极低出生体重早产儿的存活率。然而,脑室内出血(IVH)一直是早产的主要并发症之一。IVH与神经发育障碍有关,如脑瘫、语言和认知障碍以及神经感觉和精神问题,尤其是当合并脑实质损伤时。此外,需要插入分流管的严重IVH与不良神经发育结局的较高风险相关。应根据患者的生命周期为这些儿童提供多学科和纵向康复治疗。在婴儿期,基于神经运动检查检测高危婴儿并尽快提供早期干预至关重要。随着婴儿长大,需要密切监测语言和认知发育。此外,提供针对特定任务的强化重复训练的持续康复可以改善轻度至中度残疾儿童的功能结局。学龄期后,还需要维持身体活动水平并管理并发症。