Neonatal Med.  2022 Aug;29(3):117-122. 10.5385/nm.2022.29.3.117.

Case Series of Isolated Deep Gray Matter Injuries in Preterm Infants

Affiliations
  • 1Department of Pediatrics, Seoul National University Children’s Hospital, Seoul, Korea
  • 2Department of Radiology, Seoul National University Children’s Hospital, Seoul, Korea

Abstract

Hypoxic-ischemic encephalopathy in neonates is an important cause of brain damage that leads to severe neurological sequelae or death. Brain injury patterns on magnetic resonance imaging (MRI) scans are used to predict neurodevelopmental outcome severity. This case series describes the clinical manifestations and neurologic outcomes of four preterm infants with isolated deep gray matter injuries. Basal ganglia and thalamic lesions were noted without white matter and cerebral cortex lesion on brain MRI. All patients were preterm infants born at less than 33 weeks’ gestation and required resuscitation in the delivery room. All had seizures during the neonatal period requiring anti-seizure medications. Severe neurologic disability was identified in three patients using neurodevelopmental assessment tools. Another patient has not been evaluated with assessment tools yet as he was 2 months’ corrected age, but he was supported by home ventilation via a tracheostomy due to insufficient self-respiration. This case series demonstrates that isolated deep gray matter injuries in preterm infants could predict severe neurodevelopmental outcomes.

Keyword

Hypoxia-ischemia, brain; Neurologic manifestations; Basal ganglia; Thalamus

Figure

  • Figure 1. Transverse T1-weighted brain magnetic resonance imaging findings of all patients. (A) Images of patient A taken at a post-menstrual age (PMA) of 38+0 weeks. (B) Images of patient B taken at a PMA of 40+2 weeks. (C) Images of patient C taken at a PMA of 34+2 weeks. (D) Images of patient D taken at a PMA of 34+2 weeks. The arrows indicate T1 high signal intensity lesions in the deep gray matter.


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