Abstract 2007 Poster Session II, Sunday, 5/2 (poster 218)

An IVH associated with unilateral parenchymal involvement (PI) carries a high risk of the subsequent development of a hemiplegia. About one third of the cases however, have no neurological sequelae (Neuropediatrics 1998;29:180-88). We tested the hypothesis whether asymmetrical myelination of the PLIC on MRI, in newborn infants with an IVH with PI, would be a good predictor for future development of a hemiplegia.

Methods: 11 preterm infants (GA 25-34 wks) and 5 fullterm infants were studied. Using cranial ultrasound (US), the preterm infants were diagnosed to have an IVH with unilateral PI. The term infants presented with a porencephalic cyst (PC) on the first postnatal US, following an antenatal IVH with PI. MRI was performed at 40 wks postmenstrual age in the preterm infants and during the 1st wk of life in the term infants, using a 1.5 T magnet. The myelination of the PLIC was recorded, using an inversion recovery sequence (TR/TI/TE 4000/600/30), as normal, abnormal or equivocal. Neurological assessment performed ≥ 18 months corrected age reported the presence of a hemiplegia or asymmetry in tone pattern.

Results: All 4 cases with a normal PLIC had a normal outcome in spite of the development of a PC. All 9 cases with an abnormal PLIC developed a hemiplegia, while 2 of the 3 cases with an equivocal PLIC developed an asymmetry in tone and 1 was normal on neurological assessment.

Conclusion: Asymmetrical myelination of the PLIC on MRI, performed at term age in infants with an IVH and unilateral PI, appears to be an early predictor of future hemiplegia.