Evaluation of Intracranial Abnormalities by Transcranial Ultrasound in Neonates- An Observational Study

Abstract

Introduction: Intracranial abnormalities include hydrocephalus, intracranial haemorrhage and related hypoxic-ischemic damage, for which diagnosis can be confirmed by the transcranial ultrasound. Apart from this, transcranial ultrasound may also be helpful in screening of suspected intracranial infections and tumour. Various studies have demonstrated high sensitivity and specificity of transcranial ultrasound in detecting various intracranial abnormalities. Aim: To evaluate the efficiency of ultrasonography in the diagnosis of intracranial abnormalities in neonates. Materials and Methods: This observational cross-sectional study was conducted in the Department of Radiodiagnosis, SBKS MIRC Sumandeep Vidyapeeth, Piparia, Vadodara from February 2019 to August 2020. Forty neonates with abnormal neurological presentation were included in the study and detailed data regarding prenatal, perinatal and postnatal period was obtained from parents and entered in questionnaire. Length, weight was noted. Further, all the neonates were subjected to relevant blood investigations such as Complete Blood Count (CBC), blood glucose and other investigations depending upon the clinical findings. All the neonates were then subjected to transcranial ultrasonography. Results: In present study, mean gestational age of 40 neonates was 35.38±3.59. Male preponderance was noted in present study with male:female ratio of 2.08:1. Mean birth weight of neonates was 2.11±0.60. Most common mode of delivery was vaginal in 57.5% cases followed by Lower (uterine) Segment Caesarean Section (LSCS) in 27.5% cases. Antenatally, steroids are given in only 25% of the cases in present study. Most common clinical manifestation was seizures and lethargy. Transcranial ultrasound revealed germinal matrix hemorrhage in majority of neonates. Conclusion: Transcranial ultrasound is recommended in every high risk neonate as a first line modality to assess the presence of intracranial abnormalities and for timely referral to higher-centres. It is quick, inexpensive, portable, non invasive and free from ionising radiation.

Keywords

• anterior fontanelle
• germinal matrix haemorrhage
• neonatal brain
• neurosonography