Abstract
Real time (RT) ultrasonic sector scanning of the head was performed through the anterior fontanelle in 130 neonates for the following indications: birth weight <1500 g (60),suspected hypoxic ischemic injury secondary to perinatal asphyxia (16),or severe respiratory disease (12), neural tube defects (16),multiple congenital anomalies (12),abnormal head size (6),seizures (5) and cranial bruit (3). Additional diagnostic data was obtained from computerized tomographic (CT)scanning and post-mortem evaluation.
RT sonography detected 2/5 Grade I intracranial hemorrhage(ICH) 2/2 Grade II ICH, 11/11 Grade III ICH and 9/9 Grade IV ICH, as well as 1/2 vascular malformations and all 34 ventricular and 1 paraventricular abnormality. RT sonography failed to detect 3/5 Grade I ICH,4/4 subarachnoid hemorrhage and 1/2 vascular malformations that were confirmed by CT scanning and/or autopsy.Sequential RT evaluations revealed 15/31 neonates developed post-hemorrhagic hydrocephalus 2-4 weeks following hemorrhage. Blood was seen in the ventricles from 1-9 weeks. Follow up evaluations at 2-10 months revealed that 10 of 15 had enlarged but stable ventricles, 2 had shunt insertions and 3 had normal ventricular size.
The sensitivity of RT sector scanning in diagnosing moderate and severe ICH and ventricular and paraventricular abnormalities was 100%. This should be the primary modality in evaluating neonates with intracranial pathology.
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Shankaran, S., Slovis, T., Bedard, M. et al. 1609 REAL TIME ULTRASONIC SECTOR SCANNING IN DIAGNOSING INTRACRANIAL PATHOLOGY. Pediatr Res 15 (Suppl 4), 711 (1981). https://doi.org/10.1203/00006450-198104001-01626
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DOI: https://doi.org/10.1203/00006450-198104001-01626