Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Correspondence
  • Published:

Comment on ‘value of cranial ultrasound at initiation of therapeutic hypothermia for neonatal encephalopathy’

Journal of Perinatology volume 42, pages 418–419 (2022)Cite this article

Subjects

We read with interest the paper by Sanislow et al. [1]. on the role of cranial ultrasound (cUS) prior to starting therapeutic hypothermia (TH) for infants with hypoxic-ischaemic encephalopathy (HIE). They suggest that cUS is mainly used to detect major intracranial hemorrhage (ICH), a potential reason not to start TH. They compare day 1 cUSs to day 4 post-TH MRIs and argue that pre-TH cUS is unnecessary as no major ICH was detected. In our longstanding experience of admission cUS we have seldom encountered an infant with severe ICH meeting criteria for TH; such infants usually present later with a different history [2].

The main reason for performing cUS prior to TH is to look for evidence of antenatally acquired lesions, HIE mimics, congenital infections and malformations. Table 1 lists some cases we have come across over many years. Such findings are uncommon and unsurprisingly not reported among the 108 infants studied here [1]. The abnormalities in Table 1, although suggestive of non-HIE diagnoses, need confirmation and generally TH will not be withheld. Meanwhile investigations can be instituted early and parental counselling can include concerns about another possible diagnosis from the outset rather than later on.

Table 1 Observations made by the authors on admission cUS in newborn term infants presenting with encephalopathy.
Full size table

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Sanislow W, Singh E, Yang E, Inder T, El-Dib M Value of cranial ultrasound at initiation of therapeutic hypothermia for neonatal encephalopathy. J Perinatol. 2021. https://doi.org/10.1038/s41372-021-01233-0.

  2. van Steenis A, Fumagalli M, Kruit MC, Peeters-Scholte CMPCD, de Vries LS, Steggerda SJ. Cranial ultrasound is an important tool in the recognition of life-threatening infratentorial hemorrhage in newborns. Neuropediatrics. 2021;52:170–8.

    Article  Google Scholar 

  3. Nelson MD Jr, Tavaré CJ, Petrus L, Kim P, Gilles FH. Changes in the size of the lateral ventricles in the normal-term newborn following vaginal delivery. Pediatr Radio. 2003;33:831–5.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neonatology, University medical Center Utrecht, Utrecht, the Netherlands

    L. S. de Vries & F. Groenendaal

  2. Department of Neonatology, Leiden University medical Center, Leiden, the Netherlands

    L. S. de Vries & S. J. Steggerda

  3. Department of Paediatrics, Imperial College London, London, UK

    F. M. Cowan

Authors
  1. L. S. de Vries
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S. J. Steggerda
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. F. Groenendaal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. F. M. Cowan
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

LSdeV wrote the first draft of the comment and finalized it following reviews by the other authors. FC, SS and FG reviewed and approved the comment.

Corresponding author

Correspondence to L. S. de Vries.

Ethics declarations

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

de Vries, L.S., Steggerda, S.J., Groenendaal, F. et al. Comment on ‘value of cranial ultrasound at initiation of therapeutic hypothermia for neonatal encephalopathy’. J Perinatol 42, 418–419 (2022). https://doi.org/10.1038/s41372-021-01307-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41372-021-01307-z

Search

Advanced search

Quick links