Role of Cranial Ultrasonography in Evaluation of Brain Injuries in Preterm Neoanates

Abstract

Introduction: Preterm neonates have more likelihood of having neurological abnormalities due to intracranial hemorrhages, perinatal asphyxia and congenital anomalies. Early recognition of these conditions is important for proper management. Cranial ultrasonography can be used to diagnose such conditions at the bedside. Aim: The present study was undertaken with objective of detecting and grading brain injuries using neurosonogram and to evaluate the possible use in determining the prognosis and outcome at the end of the study. Materials and Methods: This was a prospective study conducted over a one year period in the pediatric Hospital, tertiary care Institute in North West part of Rajasthan (Bikaner). A total of 62 preterm babies with suspected neurological injuries were included in this study. Neurosonogram was carried out within 1 week of birth and at the end of 1 month follow-up scan was done. Results: Incidence of CUS abnormalities in preterm neonates is 16.1% in the present study. There were 62.9% male and 37.1% female neonates.11.2% of these had evidence of intracranial bleed, 1.6% periventricular echogenecity, 1.6% had ventriculomegaly and 1.6% had periventricular leukomalacia. Most common clinical presentation was seizures followed by absent suckling and lethargy. Brain injuries were found mostly in babies born before 32 weeks. The most common abnormality was grade I GMH (about 27.4%). Conclusion: Neurosonogram is the best initial method of investigation for preterm babies with suspected neurological injuries. It is best toper form neurosonogram studies on preterm babies within 1st week of birth and follow-up scan at the end of 1st month. It is non-invasive, non-ionising, widely available, cheap and repeatable.

Keywords

• germinal matrix hemorrhage
• neurosonogram
• nicu
• ventriculomegaly