Strassburg H M, Bode H, Dahmen U
Klin Padiatr. 1986 Sep-Oct;198(5):385-90. doi: 10.1055/s-2008-1033894.
After a 5 years' experience of cerebral sonography (about 4,500 recordings) in infants we are trying to establish correlations between alterations of anatomical structures and the further clinical development. Obviously there is no constant connexion between a simple subependymal haemorrhage and the further neurological symptoms. At the age of two and more years, about 30% had a normal state, the other part had very different clinical signs. Even an uncomplicated ventricular haemorrhage had no definite influence on the child's development in most cases. Ischemic infarctions seem to have a better prognosis than borderline-infarctions. Real intracranial cysts and slight brain atrophy seem to have only distinct neurological symptoms. Porencephalic defects or brain necrosis, e.g. after parenchymatous haemorrhages and infarctions as well as generalized hypoxic encephalopathies with increased echogenicy and progressive brain atrophy nearly always showed neurological defects, though the dimension of the brain's alteration does not clearly correlate to the clinical symptoms and the child's development. It is not possible to make a prognostic evaluation by cerebral sonography in hypoxic-ischemic brain-lesions within the first 3 weeks post partum. A more exact judgement will be given after further regular sonographic observations in all high-risk infants within the first year. Beyond this, technical and organisation-improvements will probably allow a more exact statement in future.
在对婴儿进行了5年的脑部超声检查(约4500次记录)后,我们试图建立解剖结构改变与后续临床发展之间的相关性。显然,单纯的室管膜下出血与后续的神经症状之间没有固定的联系。在两岁及以上的儿童中,约30%状态正常,其余部分有非常不同的临床体征。即使是无并发症的脑室出血,在大多数情况下对儿童的发育也没有明确影响。缺血性梗死似乎比边缘性梗死预后更好。真正的颅内囊肿和轻度脑萎缩似乎只有明显的神经症状。脑穿通畸形缺损或脑坏死,例如实质内出血和梗死以及回声增强和进行性脑萎缩的全身性缺氧性脑病后,几乎总是出现神经缺陷,尽管脑部改变的程度与临床症状和儿童发育没有明显的相关性。在产后前3周内,通过脑部超声检查对缺氧缺血性脑损伤进行预后评估是不可能的。在对所有高危婴儿在出生后第一年内进行进一步定期超声检查后,将给出更准确的判断。除此之外,技术和组织方面的改进可能会在未来允许做出更准确的陈述。