Microcephaly & Macrocephaly

Microcephaly & Macrocephaly

Primary prerequisite for the diagnosis of microcephaly/macrocephaly is the proper horizontal head circumference (HC) measurement (frontal-occipital circumference): supine position glabella – opisthocranion as anchor points normocephaly (32-38 cm for a term newborn) => refer to percentile graphs for your hospital, region or country percentile graphs for preterm population (Fenton graphs) sexual dimorphism…

Seizures

Seizures

There is a number of different types of seizure activity in newborns. Seizure types subtle seizures (grimace, blinking, yawning, salivation, cycling, apnea) myoclonus clonic seizures (unifocal, multifocal) tonic seizures (generalized hypertonia, decerebration-like posture, growling, apnea, bulbar deviation) Etiology congenital CNS malformations hypoxic-ischemic encephalopathy (HIE) intracranial hemorrhage (intraventricular, subdural hemorrhage) meningitis, encephalitis medication hypoglycemia,…

Congenital anomalies of nervous system

Congenital anomalies of nervous system

Congenital anomalies of nervous system can be detected by the prenatal screening (ultrasound – hydrocephalus, anencephalus; biochemistry using alpha-fetoprotein (AFP) – elevated in amniotic fluid and maternal serum in neural tube defects).  Postnatal investigations include proper clinical examination (proper head circumference measurement, neurologic symptoms, septic workup) and imaging (cranial ultrasound, magnetic resonance imaging…

Periventricular leukomalacia

Periventricular leukomalacia

The central nervous system of extremely preterm infants is highly susceptible to perinatal injuries due to the presence of immature vasculature in the germinal matrix and periventricular white matter. Furthermore, the sensitivity of cerebral tissue to hypoxia-ischemia stems from already low baseline CBF and high oxygen consumption with increased oxygen extraction. In addition, myocardial dysfunction,…

Neurodevelopment

Neurodevelopment

The central nervous system of extremely preterm infants is highly susceptible to perinatal injuries due to the presence of immature vasculature in the germinal matrix and periventricular white matter. Furthermore, the sensitivity of cerebral tissue to hypoxia-ischemia stems from already low baseline CBF and high oxygen consumption with increased oxygen extraction. In…

Intraventricular hemorrhage

Intraventricular hemorrhage

The intraventricular hemorrhage in the preterm infants usually originates in the germinal matrix (temporary developmental structure with significant vascular supply due to massive mitotic and metabolic activity). The structure is divided from the cerebral ventricles only by a thin layer of subependymal cells and disappears after 34 weeks of gestation – one…