Frequency and nature of cerebellar injury in the extremely premature survivor with cerebral palsy

We report on the frequency and variable nature of magnetic resonance imaging-documented injury to the cerebellum in children with cerebral palsy who had survived a birth with a weight under 1000 g and/or a gestational age under 28 weeks. Thirty of 67 patients who had magnetic resonance images were found to have injury to the cerebellum. Those with cerebellar injury were much more likely to be microcephalic and to be unable to walk or talk. They did not demonstrate a greater frequency of observed injury to the cerebrum. From a larger collection of children with known cerebellar injury and cerebral palsy who had a history of being extremely premature, we found that 35 of 47 patients had prominent injury to the inferior cerebellum, suggesting infarction, whereas the remainder demonstrated varying degrees of cerebellar atrophy with or without asymmetry and four also had enlarged 4th ventricles. Injury to the cerebellum in the extremely premature survivor who has cerebral palsy is common and associated with a more adverse clinical picture. The etiology of this injury is obscure.