Cerebellar infarction: An unrecognized complication of very low birthweight

We evaluated 13 children with cerebral palsy who had birthweights under 1085 g. A magnetic resonance image (MRI) of the head was obtained, the findings were compared, and the neonatal records were reviewed. The individual children were classified as to the type of cerebral palsy. On MRI, all had severe injury to the inferior cerebellar hemispheres, mostly symmetric, and in some there was injury to the inferior vermis. The average birthweight was 668 g, and the gestational ages were 24 to 27 weeks. No other outstanding prenatal or postnatal problems were identified. The children had different types of severe cerebral palsy, with only 3 being able to walk. Almost all were mentally retarded and microcephalic. All had visual problems. This report defines a previously underappreciated injury to the cerebellum in extremely premature infants. Further clinical, laboratory, and pathologic studies are needed to better define the underlying mechanisms.