Practice parameter: Neuroimaging of the neonate: [RETIRED]

Abstract

Article abstract-Objective: The authors reviewed available evidence on neonatal neuroimaging strategies for evaluating both very low birth weight preterm infants and encephalopathic term neonates. Imaging for the preterm neonate: Routine screening cranial ultrasonography (US) should be performed on all infants of Ͻ30 weeks' gestation once between 7 and 14 days of age and should be optimally repeated between 36 and 40 weeks' postmenstrual age. This strategy detects lesions such as intraventricular hemorrhage, which influences clinical care, and those such as periventricular leukomalacia and low-pressure ventriculomegaly, which provide information about long-term neurodevelopmental outcome. There is insufficient evidence for routine MRI of all very low birth weight preterm infants with abnormal results of cranial US. Imaging for the term infant: Noncontrast CT should be performed to detect hemorrhagic lesions in the encephalopathic term infant with a history of birth trauma, low hematocrit, or coagulopathy. If CT findings are inconclusive, MRI should be performed between days 2 and 8 to assess the location and extent of injury. The pattern of injury identified with conventional MRI may provide diagnostic and prognostic information for term infants with evidence of encephalopathy. In particular, basal ganglia and thalamic lesions detected by conventional MRI are associated with poor neurodevelopmental outcome. Diffusion-weighted imaging may allow earlier detection of these cerebral injuries. Recommendations: US plays an established role in the management of preterm neonates of Ͻ30 weeks' gestation. US also provides valuable prognostic information when the infant reaches 40 weeks' postmenstrual age. For encephalopathic term infants, early CT should be used to exclude hemorrhage; MRI should be performed later in the first postnatal week to establish the pattern of injury and predict neurologic outcome.

Avaliação do sistema nervoso auditivo central em neonatos com Hemorragia peri intraventricular

“…PIVH grade IV has a high mortality rate, especially when major injuries occur in low gestational age infants. 6 PIVH is one of the causes of peripheral and central auditory disorders in premature, 7 which may cause changes in the development of hearing and language. 8 Hearing and language are interrelated functions, which makes the anatomical and functional integrity of audio system crucial for the development and improvement of various hearing abilities which are performed by the peripheral and central auditory system.…”

Newborn frontal horn cysts: cause for concern?

“…1 The detection of these abnormalities is important for providing appropriate counseling to parents regarding adverse long-term neurodevelopmental outcomes in this fragile population and for enrollment in early infant development programs to reduce the impact of adverse neurological outcomes.…”

Interdisciplinary Approach to Neurocritical Care in the Intensive Care Nursery

“…42 Critically ill neonates can be safely imaged, optimally with MR imaging (MRI), which is the most sensitive imaging modality to visualize both the white and the gray matter. 43,44 Ultrasound remains an important bedside tool that is performed urgently for newborns with suspected neurosurgical conditions (eg, intracranial bleed or hydrocephalus), or when more definitive imaging using MRI will be delayed. 45 We never use computed tomography for neonates, as it requires a relatively high dose of radiation to achieve adequate image resolution.…”