Feraz N. Rahman MD, MS, Presenter: Nothing to Disclose

John H. Gilmore MD, Abstract Co-Author: Nothing to Disclose

Sandra Woolson PhD, Abstract Co-Author: Nothing to Disclose

Guido Gerig, Abstract Co-Author: Nothing to Disclose

Robert M Hamer DPHIL, Abstract Co-Author: Nothing to Disclose

Jeffrey Keith Smith MD, PhD, Abstract Co-Author: Nothing to Disclose

25% of vaginally-delivered babies have intracranial hemorrhage (ICH), but it is unknown if ICH affects brain growth. In this study, brain volumes at birth and 1-year of age as well as growth ratios are compared between babies with ICH and normal matched controls. We hypothesize that there will be no differences between the groups.

Pregnant women were recruited for a prospective study of neonatal brain development. Neonates were imaged without sedation using 3T MRI at birth and 1 year of age. 1-year scans were corrected for inhomogeneous white matter myelination. Age-specific automated atlas-based algorithms were then used to segment for tissue type and parcellate by brain region in both groups. Results were used to calculate volumes of total brain tissue (BV), cortical gray matter (CG), cerebellum (CV), and cerebrospinal fluid volume (CSF). For each of these, the volume calculated from the 1-year scan was divided by the volume calculated from the neonatal scan to calculate a growth ratio. 17 babies (8 male, 9 female) identified with ICH on neonatal MRI had successfully processed neonatal and 1-year scans (ICH Group). Each was matched to a successfully processed control of the same gender to minimize differences in gestational age at birth/MRI, maternal age, race, and maternal education. (Control Group). Neonatal and 1-year BV, CG, CV, and CSF as well as growth ratios for each volume were compared between the ICH and control groups by Wilcoxon ranksum. 

At birth, all volumes trended lower for the ICH group, though the differences were not statistically significant. At 1-year, volumes were similar between groups. Growth ratio from neonatal to 1-year of total brain tissue (ICH=2.02±0.11 vs. Control=1.92±0.09) and cortical gray matter (ICH=2.59±0.13 vs. Control=2.42±0.14) were significantly higher in the ICH group (p<0.05).

We observed increased total brain tissue and cortical grey matter volume growth in the ICH group. This implies that neonatal ICH did not hinder brain growth. The increased growth may partially be due to “catch-up” growth of slightly lower brain volumes at birth in the ICH group.

Asymptomatic neonatal ICH does not cause brain growth retardation, and is actually associated with increased growth. Catch-up growth of lower brain volume at birth may be partially responsible.  

Rahman, F, Gilmore, J, Woolson, S, Gerig, G, Hamer, R, Smith, J, Neonatal Intracranial Hemorrhage: One-year Follow-Up Reveals Association with Increased Brain Growth.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11002940.html