Consensus Approach for Standardizing the Screening and Classification of Preterm Brain Injury Diagnosed With Cranial Ultrasound: A Canadian Perspective
Mohammad, Khorshid; Scott, James N; Leijser, Lara M; Zein, Hussein; Afifi, Jehier; Piedboeuf, Bruno; de Vries, Linda S; van Wezel-Meijler, Gerda; Lee, Shoo K; Shah, Prakesh S
(2021) Frontiers in Pediatrics, volume 9
(Article)
Abstract
Acquired brain injury remains common in very preterm infants and is associated with significant risks for short- and long-term morbidities. Cranial ultrasound has been widely adopted as the first-line neuroimaging modality to study the neonatal brain. It can reliably detect clinically significant abnormalities that include germinal matrix and intraventricular hemorrhage,
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periventricular hemorrhagic infarction, post-hemorrhagic ventricular dilatation, cerebellar hemorrhage, and white matter injury. The purpose of this article is to provide a consensus approach for detecting and classifying preterm brain injury to reduce variability in diagnosis and classification between neonatologists and radiologists. Our overarching goal with this work was to achieve homogeneity between different neonatal intensive care units across a large country (Canada) with regards to classification, timing of brain injury screening and frequency of follow up imaging. We propose an algorithmic approach that can help stratify different grades of germinal matrix-intraventricular hemorrhage, white matter injury, and ventricular dilatation in very preterm infants.
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Keywords: brain injury, cranial ultrasonography, intraventriclar hemorrhage, post-hemorrhagic ventricular dilatation, preterm (birth), Pediatrics, Perinatology, and Child Health
ISSN: 2296-2360
Publisher: Frontiers Media S. A.
Note: Funding Information: This study was supported by a grant from the Canadian Institutes of Health Research (CIHR) funding the Canadian Preterm Birth Network (PBN 150642). Organizational support for the Canadian Neonatal Network and the Canadian Preterm Birth Network was provided by the Maternal-infant Care Research Centre (MiCare) at Mount Sinai Hospital in Toronto, Ontario, Canada. MiCare is supported by a CIHR Team Grant (CTP 87518), the Ontario Ministry of Health and Long-Term Care, and the participating hospitals. PSS holds a CIHR Applied Research Chair in Reproductive and Child Health Services and Policy Research (APR-126340). The funding bodies had no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or the decision to submit the manuscript for publication. Publisher Copyright: © Copyright © 2021 Mohammad, Scott, Leijser, Zein, Afifi, Piedboeuf, de Vries, van Wezel-Meijler, Lee and Shah. Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
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