Evaluation of Hypoxic Ischemic Encephalopathy and Congenital Intracranial Lesions in Preterm Using Transcranial Ultrasound and Color Doppler

Abstract

Background: Cranial ultrasound is a safe imaging modality that does not require sedation and can be performed bedside, it can be repeated as often as necessary because of the lack of ionizing radiation. This study aimed to evaluate the usefulness of transcranial ultrasound and color Doppler in detecting intracranial lesions and congenital brain anomalies in neonatal age group. Methods: This study was performed on 30 neonates, the age ranged between 1 day to 29 days age old, the study group consisted of 17 females and 13 males, from 30 cases in this study 10 cases were discharged ,6 cases were referred to other big hospitals , 4 cases were defaulted,5 cases were dead and 5 cases were on admission for more follow up regularly, the examined patients classified into 6 main groups , the normal cases seen and consists of 11 cases, the traumatic cases seen and consists of 1 patient, the congenital malformations consists of 5 patients, 3 cases were holoprosencephaly , 2 cases were septo-optic dysplasia and one case of cerebellar hypoplasia .the vascular lesions seen and consists of 10 patients 3 cases of Periventricular germinal matrix hemorrhage & 3 cases were periventricular leucomalacia (PVL) and 1 case as aneurysm of vein of Galen and 1 case of extra-axial hemorrhage and 2 cases of brain parenchymal hematomas. Results: Four main Ultrasound approaches were used; anterior fontanel (AF), [additional winows: (posterior fontanel, mastoid (poster lateral) fontanel, temporal approach]. The examined patients can be classified into 6 main groups. A) Normal cases in the study. B) Traumatic cases. Congenital cases: 3 holoprosencephaly, 2 septo-optic dysplasia,1 cerebellar hypoplasia. Sonographic findings of the congenital group. Sonographic Findings of aneurysm of Vein of Galen is seen as Anechoic cyst Shows high vascularity on Doppler, Multiple dilated surrounding feeding vessels and Supratentorial Hydrocephalus. Conclusions: US has been a major advance in the study of neonatal brain, it is portable safe, non-invasive, low cost and highly effective technique that is of considerable value in evaluation of neonatal intracranial disorders and should be included within integrated approach to CNS imaging in the neonates.