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Four neonates had previous major surgery, and all neonates had at least 1 of several complications of prematurity (respiratory distress syndrome, bronchopulmonary dysplasia, intraventricular hemorrhage, retinopathy of prematurity). Severe cranial sonographic abnormalities were considered to be grade III to IV intraventricular hemorrhage or cystic periventricular leukomalacia as examined by serial brain ultrasound using the definitions of Papile et al (37) and de Vries et al. 3) His dependence on the respirator increased, and within two days, tests were showing a significantly severe intraventricular hemorrhage (brain bleed). |
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