Outcomes in children experiencing neurologic insults as preterm neonates.

Germinal matrix-intraventricular hemorrhage, periventricular hemorrhagic infarction, and periventricular leukomalacia are common brain injuries in preterm infants that can have significant long-term influences on children's development, physical skills, and cognitive functioning. Characteristics of preterm infants, including immature cerebrovascular autoregulation, fragility of blood vessels, and the presence of the germinal matrix, increase their vulnerability to neurologic injury. Grades I-II germinal matrix-intraventricular hemorrhage tends to have little-to-moderate long-term impact on cognitive and neuromotor development after the neonatal period, while more severe hemorrhage is associated with less optimistic developmental prognoses. Periventricular leukomalacia and ventriculomegaly in the neonate are associated with severe cognitive disabilities as well as with cerebral palsy. Neurodevelopmental strategies emerging from both the neonatal developmental care and early intervention models may have a place in the post-acute care of newborns who experienced these insults. Vigilant developmental screening and early developmental intervention are essential components of the follow-up nursing care for children whose medical histories include neonatal brain injury.