The rationale for routine cerebral ultrasound in premature infants

Argyropoulou, Maria I.; Veyrac, C

doi:10.1007/s00247-014-2985-1

Cited by 12 publications

(11 citation statements)

References 34 publications

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“…Not only has ultrasound supplanted CT as the primary diagnostic tool because to its similar resolution for identifying bleeding, but also because CT has the drawback of needing the unwell preterm newborn to be transferred and exposing the brain and eyes to ionizing radiation [16] .…”

Section: Discussionmentioning

confidence: 99%

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

.Gafar

Shalan

Yousef

2022

Benha Journal of Applied Sciences

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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.

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Section: Discussionmentioning

confidence: 99%

“…Importantly, US is cheaper than CT and more accessible to many neonatal intensive care units especially in developing countries [17] However, CT is useful for identifying complicated hemorrhagic lesions such as subdural hemorrhage, hemorrhagic posterior fossa lesions, and specific cerebral parenchymal hemorrhagic abnormalities [16] .…”

Section: Discussionmentioning

confidence: 99%

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

.Gafar

Shalan

Yousef

2022

Benha Journal of Applied Sciences

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“…90% of spontaneous intra cerebral hemorrhages in premature infants are in the germinal matrix tissue, resulting severe morbidity and even mortality due to the severity of bleeding [9]. The incidence of intraventricular hemorrhage with GMB is 20% in low birth weight premature infants [4]. Post-hemorrhagic ventricular dilatation (PVHD) risk increases with severe GMB-IVH, lower gestational age and severe problems of prematurity [10].…”

Section: Discussionmentioning

confidence: 99%

“…method in the early evaluation of the cerebral parenchyma and ventricular system; it is easy and fast to access, cheap and widespread use, non-invasive, and lack of radiation. C-US is a reliable method in the evaluation of congenital or acquired intracranial pathologies in premature and term infants [4]. Because premature infants are very sensitive to hydrocephalus due to intraventricular hemorrhage, it is important to measure ventricular width by C-US to diagnose hydrocephalus, to evaluate the necessity of intervention and to evaluate clinical symptoms due to intracranial pressure increase [5].…”

Section: Introductionmentioning

confidence: 99%

Normal Values of Third Ventricular Width of Preterm Infants

Koç

Mert

2019

Acta Medica

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Objective: Although the third ventricle width reference ranges obtained by cranial ultrasonography in term infants are known in the literature but there are no adequate and up to date data regarding the reference ranges of third ventricle width in premature infants. In our study, we aimed to obtain the normal reference values of third ventricle width and the third ventricle related parameters in preterm infants (gestational age <32 weeks). Materials and Methods:In our study 156 preterm infant and 64 term infants were included. Weights and head circumference of all infants were measured before C-US. The right and left lateral ventricle anterior horn width (AHW), ventricular index (VI) and third ventricle width were recorded in C-US. Study data were divided into 2 groups as term infants and preterm infants. Results:Third ventricle measurement was successfully performed in all infants. The frequency of cesarean section was significantly higher in preterm infants, while weight and head circumference were significantly lower (p<0.05). R-AHW, L-AHW, R-VI, L-VI was significantly higher in term infants than in preterm infants (p<0.05). Mean ± SD, median, minimum and maximum third ventricle diameters were 1.27±0.33mm, 1.20mm, 0.50mm and 1.90mm respectively in preterm infants. In univariate analysis, GA, R-AHW, L-AHW, R-VI, L-VI values were found to be associated with third ventricle diameters. Linear regression analysis revealed that only GA and R-AHW were independently associated with third ventricle (beta: 0.611 - p<0.001 and beta: 0.141 - p = 0.011, respectively). Conclusion:The third ventricle width obtained by C-US is significantly lower in preterm infants than in term infants and this is independently associated with GA. These results of our study are important for the detection of third ventricle dilatation in preterm infants with abnormal C-US and our data’s were thought to be used clinically.

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“…In contrast, white matter injury can be undetectable or subtle on initial head US, when it may manifest as increased or asymmetrical periventricular white matter echogenicity [4,16,23,24]. Echogenicity may be replaced by cyst formation after approximately 1-3 weeks [4,16,23,24], and ventriculomegaly may be the only residual visible abnormality on US after the cysts are resorbed over several months [4,16,[24][25][26]. The age at which white matter injury is diagnosed on US varies widely in the literature, from 10 to 104 days [18,[27][28][29], and may depend on underlying risk factors such as perinatal depression or late-onset sepsis.…”

Section: Introductionmentioning

confidence: 99%

Rate of head ultrasound abnormalities at one month in very premature and extremely premature infants with normal initial screening ultrasound

Liu

Gano

et al. 2022

Pediatr Radiol

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Background Premature infants are at risk for multiple types of intracranial injury with potentially significant long-term neurological impact. The number of screening head ultrasounds needed to detect such injuries remains controversial. Objective To determine the rate of abnormal findings on routine follow-up head ultrasound (US) performed in infants born at ≤ 32 weeks’ gestational age (GA) after initial normal screening US. Materials and methods A retrospective study was performed on infants born at ≤ 32 weeks’ GA with a head US at 3–5 weeks following a normal US at 3–10 days at a tertiary care pediatric hospital from 2014 to 2020. Exclusion criteria included significant congenital anomalies, such as congenital cardiac defects necessitating surgery, congenital diaphragmatic hernia or spinal dysraphism, and clinical indications for US other than routine screening, such as sepsis, other risk factors for intracranial injury besides prematurity, or clinical neurological abnormalities. Ultrasounds were classified as normal or abnormal based on original radiology reports. Images from initial examinations with abnormal follow-up were reviewed. Results Thirty-three (14.2%) of 233 infants had 34 total abnormal findings on follow-up head US after normal initial US. Twenty-seven infants had grade 1 germinal matrix hemorrhage, and four had grade 2 intraventricular hemorrhage. Two had periventricular echogenicity and one had a focus of cerebellar echogenicity that resolved and was determined to be artifactual. Conclusion When initial screening head ultrasounds in premature infants are normal, follow-up screening ultrasounds are typically also normal. Abnormal findings are usually limited to grade 1 germinal matrix hemorrhage.

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The rationale for routine cerebral ultrasound in premature infants

Cited by 12 publications

References 34 publications

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

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

Normal Values of Third Ventricular Width of Preterm Infants

Rate of head ultrasound abnormalities at one month in very premature and extremely premature infants with normal initial screening ultrasound

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