Neurodevelopmental Consequences of Preterm Isolated Cerebellar Hemorrhage: A Systematic Review

Pediatrics. 2018 Nov;142(5):e20180609. doi: 10.1542/peds.2018-0609. Epub 2018 Oct 19.


Context: The effect of neonatal cerebellar hemorrhage on neurodevelopmental outcome (NDO) in the absence of supratentorial injury is still largely unknown.

Objective: To evaluate the influence of isolated neonatal cerebellar hemorrhage on cognitive, motor, language, and behavioral NDOs and assess the effect of location and size on outcome.

Data sources: Embase, Medline, and Scopus were searched from inception to September 30, 2017.

Study selection: Studies in which a diagnosis of isolated cerebellar hemorrhage was reported in preterm infants (<32 weeks' gestation) with a standardized NDO at ≥12 months of age were included.

Data extraction: Patient characteristics, location, and size of bleeding and NDO (defined as severe [yes or no] on the basis of given cutoff points) in 4 domains were extracted.

Results: Of the 1519 studies identified, 8 were included in final analyses. Of infants with isolated cerebellar hemorrhage, 128 were described (cumulative incidence: 2.3%). The incidence of severe delay in cognition, motor, language, and behavioral development was 38%, 39%, 41%, and 38%, respectively. The overall incidence of severe neurodevelopmental delay in ≥1 domain ranged from 43% to 75% and was most seen in infants with vermis involvement (87%-93%) and with large bleeds (46%-82%).

Limitations: Different neurodevelopmental scales lead to data heterogeneity, and reporting of data on a group level limited possibilities for an outcome description on an individual level.

Conclusions: Of infants with isolated cerebellar hemorrhage, 43% to 75% were severely delayed in cognition, motor, language, and/or behavioral development, with the highest incidence with vermis involvement and with large bleeds.

Publication types

  • Systematic Review

MeSH terms

  • Cerebral Hemorrhage / complications*
  • Developmental Disabilities / epidemiology
  • Developmental Disabilities / etiology*
  • Humans
  • Incidence
  • Infant
  • Infant, Newborn
  • Infant, Premature
  • Infant, Premature, Diseases / etiology*