Brain injury and ocular motor abnormalities in surviving preterm infants

Advances in neonatal care over the past 10 years have resulted in increased survival of very immature preterm infants but there has not been a corresponding improvement in neurodevelopmental outcome.1 Serious neonatal morbidity is associated with decreasing gestational age. The survival of infants of extremely low birth weight and gestational age is associated with an increased incidence of brain injury in the survivors. The immature central nervous system of premature infants is particularly susceptible to cerebrovascular damage.2-4 Intracranial, particularly intraventricular, haemorrhage is common, especially in smaller infants and may be associated with post-haemorrhagic hydrocephalus and with focal infarction of the white matter. The haemorrhage arises from the subependymal germinal matrix, a fine vascular gelatinous structure lying beneath the ependyma of the ventricular system and containing cells which will form mature glial cells that will later populate the cortex.2 4 The germinal matrix is present from 10 weeks’ gestational age and has disappeared by term. Most haemorrhage occurs in the first 72 hours after birth and may …