Wake Forest Magazine September 2003 - Past Issues - Wake Forest ...

LOUIS DAVISFinding AnswersWake Forest School of Medicine researcher has identified brain malformations that appearA to be part of a syndrome that could be a leading cause of death in premature infants.William R. Brown, director of the Brain Microvascular Pathology Laboratory, has discovered a newtype of brain malformation, called cortical cleft malformation, which is associated with prematurebirth and early death. “The brain malformations may result from blood clots that circulate from theplacenta to the developing brain,” Brown said. “This would cause cell death and a hole to form calleda cortical cleft. This finding suggests an answer to the question, ‘Why did this baby die?’ to parents andphysicians who look for underlying medical causes to explain the death of many preterm babies.”The malformations were found using ultrasound and MRI scans during autopsies of prematureinfants. Over a nine-year period Brown and his team looked at brain tissues from thirty-threebabies; thirty-one had the malformations.While it is not yet known how to prevent the malformations, Brown and his team hope thatby understanding how they occur, prevention strategies can be developed. “We suspect from ourstudies that the lesions originate early in pregnancy around the end of the first trimesteror start of the second trimester,” he said. “Sometime after the damage to the brain has occurred,something causes the mother to go into premature labor. Babies with large malformations die withinhours or days of birth. We don’t know why the mother goes into early labor or why the babies die,but it appears to be due to a syndrome involving these brain malformations.”Babies may live with less severe forms of these malformations, but researchers suspect any survivorsmay suffer from other conditions which often have no known cause. “By answering some of thesequestions, we may be able to prevent premature births and brain dysfunctions such as cerebralpalsy and mental retardation,” Brown said.For neonatalogists, this breakthrough could mean the answers to questions that have beenhaunting physicians for years. “This finding is very exciting for many reasons,” said Steve Block, aneonatalogist and director of the Neonatal Intensive Care Unit. “It is so unusual to have a findingthat is completely novel. If we start to look at causation, then we can begin to explore therapiesthat might prevent some devastating diseases. The ultimate goal is a healthy baby and moreproductive member of society.”September 2003 19