Volpe J J
Harvard Medical School and Children's Hospital, Boston, Mass 02115, USA.
Arch Neurol. 1998 Mar;55(3):297-300. doi: 10.1001/archneur.55.3.297.
Brain injury in the premature infant is an extremely important problem, in part because of the large absolute number of infants affected yearly. The 2 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 neuropathological features, pathogenesis, and potential means of prevention of these 2 lesions. Recent work suggests that the ultimate goal, prevention of the lesions, is potentially achievable. Periventricular hemorrhagic infarction may be avoidable 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的婴儿绝对数量众多。早产儿随后出现的神经学表现所基于的2种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2种损伤的神经病理学特征、发病机制以及潜在的预防方法。最近的研究表明，预防这些损伤这一最终目标有可能实现。通过预防生发基质-脑室内出血可避免脑室周围出血性梗死，通过检测脑血管自动调节功能受损、预防脑血流受损以及使用自由基清除剂等药物阻断向少突胶质细胞死亡的级联反应来预防脑室周围白质软化。
