Timing of neonatal cerebroventricular haemorrhage with ultrasound.

Abstract

SUMMARY Sequential real-time ultrasound examinations were performed in 174 neonates to determine the time of occurrence of cerebroventricular haemorrhage (CVH). Of Real-time ultrasound equipment has assumed an important role in the detection of intraventricular haemorrhage in preterm infants. Since there is no known risk ofthe procedure and minimal disturbance to the neonate during its use, we considered it could be employed serially to time the occurrence of cerebroventricular haemorrhages (CVH) (that is germinal layer or intraventricular haemorrhage). Subjects and methodsDuring a 12-month period all infants weighing less than 1500 g at birth, together with those exceeding this weight who had other risk factors-such as severe hyaline membrane disease requiring assisted ventilation-were examined using an ADR real-time ultrasound scanner with a 7 MHz linear array transducer. Examinations were performed as soon as possible after birth, repeated daily for 3 days, and then again at one week. The brain was examined using a series of oblique coronal sections through the anterior fontanelle by angling the transducer forwards then slowly rotating it backwards with the anterior fontanelle as the fulcrum. CVH was diagnosed when the appearance of echogenic blood clot was visible in, or immediately inferolateral to, the lateral ventricle. The extent of the haemorrhage in the anteroposterior direction was assessed by an oblique parasagittal scan. We had confirmed the accuracy of our technique previously by comparison with computerised tomography (CT) scans and necropsy results.' Results A total of 174 infants was studied. In 47 CVH was detected. Of the 124 infants of birthweight less than 1500 g, 38 (31°) developed CVH. Of the 16 infants of birthweight less than 1500 g who were outbom, 9 (56%) developed CVH (all these being present at the time of admission to our hospital), while haemorrhage occurred in 29 (27%) of the 108 very low birthweight infants born within the hospital. This difference was statistically significant (P = 0.04,

Cranial ultrasound in preterm infants: long term follow up.

“…Haemorrhages and ischaemia may coexist in several infants, resulting in changes attributable to both. Thus after some time the extent of perinatal haemorrhagic or ischaemic trauma, or both to the preterm newborn's brain will be reflected by the presence of cystic lesions of the parenchyma and the size and shape of the ventricular system.1622 [27][28][29][30][31][32] Several studies have reported cranial ultrasound follow up in high risk preterm infants. 17 19 21 22 27 28 31 Most follow up, however, is limited to a few weeks or months while the infant is admitted to the neonatal unit.…”

Intra-ventricular hemorrhage and method of delivery of very low birth weight infants

“…KOSMETATOS reports a statistical significant effect of mode of delivery through a multiple regression analysis [12]. The timing of IVH within the first day of life in the majority of cases [4] points at causal factors operating during labor, delivery and the first few hours of life. A pathogenetical model involving changes in cardio-respiratory function, changes in blood pressure and cerebral blood flow as well as a result of an impaired autoregulation has been commonly proposed [17,18].…”

Biochemical timing of peri-intraventricular hemorrhage assessed by perinatal CPK-BB isoenzyme measurements

“…The true timing of PIVH is a crucial information to an understanding of etiologic factors and their possible prevention [7,12]. Transfontanelle real-time ultrasonography (US) has been used as method of choice to detect and follow PIVH [14].…”