New practice guidelines focus on neuroimaging of premature and low birth weight babies

ST. PAUL, MN -- The American Academy of Neurology and the Child Neurology Society have released new recommendations regarding the use of brain imaging of preterm and term infants. The guidelines are published in the June 25 issue of Neurology, the scientific journal of the American Academy of Neurology. The American Academy of Pediatrics, the American Society of Pediatric Neuroradiology, and the Society for Pediatric Radiology also endorsed the guidelines.

According to Laura R. Ment, MD, Yale University School of Medicine, an author of the guidelines, "Survival rates have steadily increased among babies born early or with low birth weight. Unfortunately, the incidence of cerebral palsy has not declined in 10 years, and the population of infants at risk is growing. Neuroimaging of the developing brain has become an important tool for diagnosing, decision-making, and evaluating treatment effectiveness."

Although neuroimaging has proven to be extremely helpful for the assessment of injury to the preterm infant's brain, and may provide useful information for evaluating the infant with neonatal encephalopathy, there are significant problems associated with imaging of the critically ill infant.

"The choice of imaging technique, the timing of the imaging study, and regional variations in maturation of the developing brain all factor into the best use of neuroimaging," said Ment.

Briefly, the recommendation states that all preterm neonates born under less than 30 weeks gestation should receive screening cranial ultrasonography (US) once they are between 7 and 14 days old, and the screening should be repeated when they have reached 36 to 40 gestational weeks. The screening is recommended to detect lesions such as major hemorhages or white matter damage that might affect the infant's neurodevelopment. There is little evidence to support routine MRI of all very low birth weight preterm infants with abnormal results from the cranial US test

Contact: Cheryl Alementi
American Academy of Neurology

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