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Association of enlarged extra-axial spaces and subdural hemorrhage in preterm infants at term-equivalent age

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Abstract

To determine the incidence of enlarged extra-axial space (EES) and its association with subdural hemorrhage (SDH) in a regional cohort of preterm infants. As part of a prospective cohort study of 395 preterm infants, brain magnetic resonance imaging (MRI) was collected on each infant at term-equivalent age. Six preterm infants showed evidence of SDH. We reviewed the MRIs to identify the incidence of EES in these 6 infants and the cohort broadly. We then completed a retrospective chart review of the 6 infants to identify any concerns for non-accidental trauma (NAT) since the MRI was obtained. The incidence of SDH in the cohort was 1.6%. The incidence of EES was 48.1% including all 6 infants with SDH. The incidence of SDH in infants with EES was 3.2%. The retrospective chart review of the 6 infants did not yield any evidence of NAT. The incidence of EES and SDH in our cohort was significantly higher than similar cohorts of term infants, demonstrating an increased risk in preterm infants. The incidence of SDH in infants with EES was greater than in the total cohort, suggesting that it is a risk factor for asymptomatic SDH in preterm infants.

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Abbreviations

CT:

Computed Tomography

EES:

Enlarged Extra-axial Space

ED:

Emergency Department

FA:

Flip Angle

MRI:

Magnetic Resonance Imaging

MS:

Milliseconds

NAT:

Non-Accidental Trauma

NICU:

Neonatal Intensive Care Unit

SDH:

Subdural Hemorrhage

TE:

Echo Time

TR:

Repetition Time

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Funding

This work was supported by the National Institute of Neurological Disorders and Stroke (5R01NS094200 and 5R01NS096037) and by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (5T32HD098061).

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Authors and Affiliations

  1. Division of Newborn Medicine, Boston Children’s Hospital, 300 Longwood Avenue | Enders 961, Boston, 02115, MA, United States

    Puneet Sharma

  2. Neurodevelopmental Disorders Prevention Center, The Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, United States

    Puneet Sharma, Beth M. Kline-Fath, Shanmukha Mukthapuram & Nehal A. Parikh

  3. Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, United States

    Beth M. Kline-Fath, Shanmukha Mukthapuram, Robert A. Shapiro & Nehal A. Parikh

  4. Department of Radiology, Cincinnati Children’s Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, United States

    Beth M. Kline-Fath

  5. Envision Physician Services, Wellington Regional Medical Center, Wellington, United States

    Shanmukha Mukthapuram

  6. Mayerson Center for Safe and Healthy Children, Cincinnati Children’s Hospital Medical Center, Cincinnati, United States

    Robert A. Shapiro

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  1. Puneet Sharma
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  2. Beth M. Kline-Fath
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  3. Shanmukha Mukthapuram
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  4. Robert A. Shapiro
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  5. Nehal A. Parikh
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Correspondence to Puneet Sharma.

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Sharma, P., Kline-Fath, B.M., Mukthapuram, S. et al. Association of enlarged extra-axial spaces and subdural hemorrhage in preterm infants at term-equivalent age. Emerg Radiol (2024). https://doi.org/10.1007/s10140-024-02250-0

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  • DOI: https://doi.org/10.1007/s10140-024-02250-0

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