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Patología Revista Latinoamericana

2012, Número 3

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Patol Rev Latinoam 2012; 50 (3)


Disorders of cerebellar growth and development in preterm neonates. A neuropathological study

Jones M, Mijalovsky A, Valencia M

Idioma: Español
Referencias bibliográficas: 88
Paginas: 190-205
Archivo PDF: 543.32 Kb.


RESUMEN

A fin de evaluar el desarrollo posnatal del cerebelo se analizaron 92 casos correspondientes a recién nacidos pretérmino y a término de hasta 7 días de vida (casos control) y recién nacidos pretérmino con edad posconcepcional equivalente al término. Se observó reducción del peso del cerebelo, disminución de la foliación y de la altura de las folias; disminución del espesor de la capa molecular y de la densidad de la capa de granos interna y aumento en la cantidad de células de Purkinje por segmento. Estos resultados se correlacionaron entre sí y con el peso corporal y cerebral, pero no con la edad gestacional. Las imágenes de necrosis, apoptosis en la corteza inmadura, astrocitosis reactiva y microgliosis en la sustancia blanca se correlacionaron con episodios de hipoxia-isquemia, infecciones, desnutrición y diversos tratamientos. Los casos estudiados mostraron una suma de lesiones directas y alteraciones del desarrollo que resultaron en patrones similares a los hallados en cerebelos de 30-35 semanas de edad gestacional aun cuando estos recién nacidos pretérmino habían completado la edad posconcepcional equivalente al término. Interpretamos estos hallazgos como una consecuencia de la acción de injurias que actuaron durante la ventana de vulnerabilidad de los hemisferios cerebelosos. Las lesiones directas de la corteza y sustancia blanca del cerebelo son una importante y poco conocida causa de alteración del crecimiento del cerebelo.


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