Intracranial hemorrhage (ICH) in neonates is an acquired lesion with enormous potential impact on morbidity , mortality , and long-term neurodevelopmental outcome.this study was done to study the prevalence of ICH in preterm neonates without any neurological signs detected and to determine the different obstetric and neonatal risk factors associated with the development of ICH .Casecontrol study throughout the period from June 2011 to December 2011 .This study was conducted on 58 preterm neonates who were admitted to Neonatal Intensive Care Unit (NICU) of Obstetrics and Gynecology Hospital , Ain Shames University. Detailed history taking: maternal, obstetric and delivery circumstances laying stress on maternal and obstetric risk factors of ICH. Assessment of the general condition using APGAR score at 1and 5 minutes. Assessment of gestational age (GA) using Ballard score. Assessment of birth weight, thorough clinical examination laying stress on neurological examination according to Sarnat. Imaging studies using cranial ultrasound (CUS) on 3rd days of life. The prevalence of asymptomatic cases with ICH was 60.7 %. There are certain maternal and neonatal risk factors that are associated with increased risk of ICH. CUS can be considered as a specific and sensitive indicator for occurrence of ICH Introduction: Intracranial hemorrhage (ICH) in neonates is an acquired lesion with enormous potential impact on morbidity, mortality, and long-term neuro-developmental outcome {1}. Bleeding within the skull can occur external to the brain into the epidural, subdural or subarachnoid space, into the parenchyma of the cerebrum or cerebellum or, into the ventricles from the subependymal germinal matrix (GM) or choroids plexus {2}. Of all types of ICH, germinal matrix-intraventricular hemorrhage (GM-IVH) is the most common and distinctive pathology {3}. Periventricular-intraventricular hemorrhage (PIVH) is a major cause of neurological disabilities in preterm newborns {4}. Diagnosis typically depends on clinical suspicion, when an infant presents with typical neuralgic signs such as, seizures, irritability, or depressed level of consciousness and or with focal neuralgic deficits referable either to the cerebrum or brain stem {5}. The associated clinical signs of IVH are typically nonspecific or absent, therefore it is recommended that premature infants < 34 week GA should be evaluated with routine real time CUS through the anterior fontanel to screen for IVH within the first 3-5 days of age. CUS is the preferred imaging technique for screening because it is non-invasive, portable reproducible, sensitive and specific for detection of IVH {6, 7, and 8}Aim of this study Studying the prevalence of ICH in preterm neonates without any neurological signs detected and Assessing the different obstetric and neonatal risk factors associated with the development of ICH Patients This case-control study was conducted on 58 preterm who were admitted to Neonatal Intensive Care Unit
