Cranial ultrasound in critically ill neonates

Abstract

Introduction: Cranial ultrasound has been widely used in neonates for early detection of intra-cranial abnormalities like intra-ventricular haemorrhage, cerebral oedema, any structural anomalies etc. It is a convenient, non-invasive, safe with least radiation exposure and quick imaging technique to visualize the neonatal brain parenchyma and ventricular system. Objective: To study the use of cranial ultrasound in the critically ill neonates admitted in the Neonatal intensive care unit. Materials and methods: This was a Cross sectional study done in NICU, GMCH, Miraj in the month of May-June 2017. These 80 critically ill Neonates according to the inclusion and exclusion criteria were subjected to cranial ultrasonography as per the protocols and different abnormalities noted and then evaluated. Clinical correlation with the USG findings was noted. Results: 28.75% of the sick neonates admitted in the NICU had abnormal cranial USG findings. Detection of abnormal finding on cranial ultrasound in the sick neonates was found to be significant. Amongst these 30.43% had cerebral oedema, 30.43% had intra-ventricular haemorrhage, 13.04% had cerebral oedema and IVH both, 8.70% had dilatation of ventricles with IVH and 17.40% had dilatation of ventricles. Occurrence of cerebral oedema in term babies and intra-ventricular haemorrhage in Pre-term babies was found to be significant in the study. Discussion: The occurrence of abnormal Cranial USG (28.75%) was significant in our study and was in correlation with similar studies which showed occurrence of 31%. Majority of babies had cerebral oedema and intra ventricular haemorrhage. The abnormal USG was significantly associated with HIE-2 and Pre-term (<32 weeks) babies. Conclusion: Cranial Ultrasonography is a feasible and effective modality to screen critically ill neonates and aid in early detection and management of these sick neonates.