Learning objectives
1.
To evaluate the ultrasound brain anatomy and anatomical landmarksin neonates
2.
To analyze the different patterns of brain injury,
differentiating two groups,
premature and term infants
Background
Brain lesions are a major cause of morbi-mortality in neonates.
Hypoxic-ischemic injuries have an incidence of 1-8 cases/1000 births and are responsible for up to 25% of all neonatal deaths.
In this age group,
usually they present with nonspecific manifestations that also appear in different pathologies like enterocolitis,
various infections and metabolic disorders [1,
2].
Hence,
it was necessary to develop a rapid and cost-effective method with good sensibility in order to depict the hypoxic-ischemic lesions.
The impact of the correct diagnostic and treatment is...
Imaging findings OR Procedure details
We reviewed the ultrasound (US) imaging studies obtained in a group of premature and term neonates.
The studies were performed with high frequency linear array transducer (10 mHz),
by direct contact with the anterior fontanelle,
using a standardized protocol with sagittal and coronal images of the whole brain.
We evaluated the anatomy in premature and term infants (Fig. 1-Fig. 5).
Among the group of patients with pathology we classified brain injuries according to the two different groups:
I-Hypoxic-ischemic brain injury in the premature infants(Fig. 6-Fig....
Conclusion
US may provide important information about brain anatomy and development in neonates.
US should be the initial examination in all neonates at high risk for hypoxic-ischemic lesions and intracranial hemorrhage and it is important to evaluate these injuries early in their course.
The pattern of involvement differs between premature and term infants.
US provides useful data and can be used in the follow up to document the evolution of lesions.
References
1.
De Vries LS,
Eken P,
Dubowitz LMS.
The spectrum of leukomalacia using cranial ultrasound.
Behav Brain Res.
1992;49:1-6.
2.
Sie LT,
van der Knaap MS,
van Wezel-Meijler G,
et al.
Early MR features of hypoxic-ischemic brain injury in neonates with periventricular densities on sonograms.
AJNR Am J Neuroradiol.
2000;21:852-61.
3.
Papile L,
Burstein J,
Burstein A,
et al.
Incidence and evolution of subependymal and intraventricular hemorrhage.
A study of infants with birth weights less than 1500 gm.
J Pediatr.1978;92:529-34.
4.
Mack LA,
Wright K,...