A study of neurosonogram abnormalities, clinical correlation with neurosonogram findings, and immediate outcome of high-risk neonates in Neonatal Intensive Care Unit

Abstract

Background:Neonatal sonography of the brain is now an essential part of newborn care, particularly in high risk and unstable premature infants. Cranial ultrasound is the most available and easily repeatable imaging technique for the neonatal brain showing brain development and the most frequently occurring forms of cerebral injury in the preterm and terms. This study aims to assess the importance of cranial ultrasound as an investigatory modality for high-risk neonates and to find out the morphology of various cerebral lesions and correlate clinically.Methodology:An observational correlation clinical study was conducted at Sardar Patel Medical College, Bikaner involving 100 high-risk neonates admitted to Neonatal Intensive Care Unit (NICU) who was subjected to neurosonography on selected days as per protocol. Perinatal details were recorded, and clinical examination with appropriate investigations was done. The cranial ultrasound was done, and morphology of various findings was studied and recorded. Clinical correlation with cranial ultrasound findings and follow-up was done.Results:On cranial ultrasound, 38% of neonates had abnormal findings. Twelve percent of these had evidence of intracranial bleed, 13% periventricular echogenicity, 7% had ventriculomegaly, 2% had cerebral edema, and 1% had leukomalacia. Three neonates had findings suggestive of simple cyst in middle cranial fossa, agenesis of corpus callosum, and choroid plexus cyst.Conclusions:Cranial ultrasonography is the best point of care neuroimaging method available for high-risk neonates. It is critical as an investigatory modality in NICU and effectively documents morphology of cerebral damage.

Study of cranial ultrasound its correlation with perinatal risk factors and its outcome in preterm neonates admitted to Neonatal intensive care unit

“…Our results are comparable to Brad way et al study who reported 37% abnormality in early sonography [14]. Most of the other Indian reports have reported incidence of 25.45%, 29.8%, 36%, 38% [5,6,8,15]. However these studies have not specified the exact time of neurosonography.…”

“…Previous studies by Bradway et al and Prithviraj et al also reported similar findings with incidence of intraventricular hemorrhage to be 38% and 43% respectively [8,14]. Nagraj et al and Jha et al, two Indian studies reported periventricular echogenicity as the most common finding [5,15].…”

“…Pediatric Review: International Journal of Pediatric Research Available online at: www.pediatricreview.in 170|P a g e Cranial ultrasound detects most of hemorrhagic, ischemic and cystic brain lesion as well as calcification, cerebral infarction and major structural anomalies congenital or acquired [5]. It is very useful in early diagnosis, assessing severity and neurodevelopmental outcome in hypoxic-ischemic encephalopathy (HIE).…”

“…In seriously ill neonates with cerebral abnormality it plays a role in decision on continuation or with drawal of intensive treatment. In preterm neonates surviving with cerebral injury, it may help to optimize treatment in neonatal period and even thereafter [5,6,8,9].…”

“…Cranial ultrasound (CUS) has become an essential diagnostic tool in neonatology as it can depict normal anatomy and pathological changes in neonatal brain. Cranial ultrasound is a technique for scanning the brain using high-frequency sound waves through their fontanelle, which provides an "acoustic window" [5,6,7].…”