Volpe J J
Harvard Medical School, Boston, MA, USA.
Brain Dev. 1997 Dec;19(8):519-34. doi: 10.1016/s0387-7604(97)00078-8.
Brain injury in the premature infant is an extremely important problem, in part because of the large absolute number of infants affected yearly. The two principal brain lesions that underlie the neurological manifestations subsequently observed in premature infants are periventricular hemorrhagic infarction and periventricular leukomalacia. The emphases of this article are the neurology, neuropathology and pathogenesis of these two lesions. Recent work suggests that the ultimate goal, prevention of the lesions, is potentially achievable. Periventricular hemorrhagic infarction may be preventable by prevention of germinal matrix-intraventricular hemorrhage, and periventricular leukomalacia, by detection of impaired cerebrovascular autoregulation, prevention of impaired cerebral blood flow and interruption of the cascade to oligodendroglial cell death by such agents as free radical scavengers.
早产儿脑损伤是一个极其重要的问题，部分原因是每年受影响婴儿的绝对数量众多。早产儿随后出现的神经学表现所基于的两个主要脑损伤是脑室周围出血性梗死和脑室周围白质软化。本文的重点是这两种损伤的神经学、神经病理学和发病机制。最近的研究表明，预防这些损伤这一最终目标有可能实现。脑室周围出血性梗死可通过预防生发基质-脑室内出血来预防，而脑室周围白质软化可通过检测脑血管自动调节受损、预防脑血流受损以及使用自由基清除剂等药物中断向少突胶质细胞死亡的级联反应来预防。
