OBJECTIVESIt is confirmed that most neonatal subependymal cysts (SEC) are closely correlated with intrauterine infection and the short-term prognosis of SEC is not very good. Little information about the long-term prognosis of SEC is available. The purpose of the present study was to explore the short-term and long-term prognosis of neonatal SEC cases via a 6-year follow up.

METHODSSeventy SEC neonates detected by cranial ultrasound between October 1993 and October 1994 were enrolled into SEC group and 70 healthy neonates into control group. Serum antibodies (IgG and IgM) to cytomegalovirus (CMV), toxoplasma and rubella virus and PCR for these pathogens (except for rubella virus) were measured in the two groups. CMV-PCR was also performed for urine specimens. Cranial sonography assessment, physical growth evaluation, Bayley developmental scale or Wyeth developmental scale, brain-stem auditory evoked potential (BAEP) and vision examination were undertaken at 3, 6, 12 months and 6 years in the two groups.

RESULTSThe positive rate of CMV-IgM and blood CMV-PCR in SEC group was significantly higher than those of control group (19.1% vs. 5.7%, 12.9% vs. 2.9%). The positive rate of urine CMV-PCR in SEC group was also significantly higher (40% vs 17.1%). No significant difference could be found in the positive rate of PCR for toxoplasma and rubella-IgM between the two groups. The weight and height of infants with SEC were obviously lower than those in control group during the first year after birth. The parameters of the physical development in SEC infants reached the similar level as controls till 6 years old. However, the index of mental development below 80 was more often seen in infants with SEC comparing to that in control group during the whole six years. There were no abnormal findings either in BAEP or vision examination in the two groups.

CONCLUSIONInfants with SEC may show a transient retardation of physical growth after birth, while their mental developmental retardation might last for longer time. It is suggested that cranial ultrasound examination should be performed in all neonates for the detection of SEC, and a longer follow-up should be done for infants with SEC.