Cranial Sonographic Findings Research Articles

Assessment of Hypoxic Ischemic Changes in Perinatal Asphyxia of First Ultasonogram of Brain

Background: In in perinatal asphyxia, hypoxic ischemic brain injury remains most serious condition causing significant mortality and long term morbidity. Early detection of intracranial changes and its consequences will enhance timely intervention and better out come. Cranial sonography can be done to assess the abnormalities of brain in perinatal asphyxia. Objectives: The objective of this study was to evaluate usefulness of assessment of Hypoxic Ischemic Changes in perinatal asphyxia of first Ultasonogram of Brain. Methods: This was an observational study conducted from March 2018 to February 2019 at department of radiology and imaging, Dhaka Shishu Children Hospital, Dhaka, Bangladesh. Total 100 neonates with perinatal asphyxia were included in this study. Cranial USG was done in all cases and sonographic abnormalities were evaluated. Result: This study was 56 term (>37 weeks of gestation) and 44 preterm (<37 weeks of gestation) newborn having birth asphyxia were taken as cases in this study. Common cranial sonographic findings of preterm babies were periventricular leukomalacia 29% (13), germinal matrix hemorrhage 14% (6), Intraventricular hemorrhage 11% (5) cerebral oedema 7% (3) and normal 39% (17). Common cranial USG findings in term babies were cerebral oedema 43% (24), intracerebral hemorrhage 5% (3), Focal cerebral infarct 4% (2), Intraventricular hemorrhage 2% (1) and normal 46% (26). Conclusion: This study found that transcranial sonography is useful to identify the abnormalities in brain of asphyxiated neonate and helps to predict the neurodevelopmental outcome. So proper management plan can be done.

Neonatal cranial sonography: ultrasound findings in neonatal meningitis-a pictorial review.

Neonatal bacterial meningitis is a common manifestation of late onset neonatal sepsis. Cranial sonography (CRS) has a crucial role in assessment of infants with clinical suspicion of bacterial meningitis as well as follows up of its complications. CRS is performed with high frequency transducer through anterior fontanelle in both coronal and sagittal planes. Various sonographic findings range from echogenic and widened sulci, ventriculomegaly, ventriculitis, hydrocephalus, extra-axial fluid collections, cerebritis and brain abscess. Sonography is extremely beneficial in evaluating intraventricular contents, especially debris and intraventricular septations. Linear high frequency probe along with color Doppler interrogation are of utmost importance in evaluating extra-axial fluid collection and helps differentiating it from benign subarachnoid space enlargement. Due to low cost, easy portability, speed of imaging, no need for sedation and above all lack of ionizing radiation make it superior to other cross sectional imaging, like CT and MRI, in evaluation of these sick neonates. Apart from textbooks, there is paucity of recently available literature on cranial sonographic findings in neonatal meningitis. This article is written with an educational intent to review the spectrum of findings in neonatal meningitis, with stress on findings that will be beneficial in the clinical practice.

Assessment of Cranial Sonographic Findings of Hypoxic Ischemic Brain Injury in Perinatal Asphyxia

Background: In perinatal asphyxia, hypoxic ischemic brain injury remains most serious condition causing significant mortality and long term morbidity. Early detection of intracranial changes and its consequences will enhance timely intervention and better out come. Cranial sonography can be done to assess the abnormalities of brain in perinatal asphyxia. Objectives: The objective of this study was to evaluate usefulness of cranial sonography in perinatal asphyxia.Methods: This was an observational study conducted from March 2014 to February 2015 at department of radiology and imaging, Enam Medical College and Hospital. Total 100 neonates with perinatal asphyxia were included in this study. Cranial USG was done in all cases and sonographic abnormalities were evaluated.Result: 56 term (>37 weeks of gestation ) and 44preterm (<37 weeks of gestation ) newborn having birth asphyxia were taken as cases in this study. Common cranial sonographic findings of preterm babies were periventricular leukomalacia 29% (13), germinal matrix hemorrhage 14% (6), Intraventricular hemorrhage 11% (5) cerebral oedema 7% (3) and normal 39% (17). Common cranial USG findings in term babies were cerebral oedema 43% (24), intracerebral hemorrhage 5% (3), Focal cerebral infarct 4% (2), Intraventricular hemorrhage 2% (1) and normal 46% (26).Conclusion: This study found that transcranial sonography is useful to identify the abnormalities in brain of asphyxiated neonate and helps to predict the neurodevelopmental outcome. So proper management plan can be done.J MEDICINE January 2016; 17 (1) : 12-16

Neonatal bacterial meningitis in Turkey: epidemiology, risk factors, and prognosis

We aimed to determine the incidence, etiology, risk factors and outcome of bacterial meningitis in neonates. Neonates who developed bacterial meningitis between 2003 and 2010 in a tertiary hospital in Turkey were included in the study. Patients born in our hospital were defined as Group 1 and patients referred from other centres were defined as Group 2. Patients with evidence of congenital infections or central nervous system malformations were excluded. Demographic features, delivery type, time of onset of meningitis, co-morbidities, clinical features, blood and cerebrospinal fluid (CSF) analysis, cranial sonographic findings, and outcome of patients were recorded. The study comprised 325 meningitis cases identified from 38,023 hospitalised patients in the neonatology unit among 11,8091 live births. Mean gestational age, birth weight, and hospital stay were 36.8 ± 3.7 weeks, 2.480 ± 924 g, and 26 ± 12.4 days, respectively. Almost half (48%) of the patients were diagnosed in the first seven postnatal days and 52% at 8-30 days after birth. CSF culture findings were positive in 59 (18%) patients (28 in Group 1 and 31 in Group 2). Gram-positive bacteria were the responsible agents in 30 (51%) patients, whereas 26 (44%) patients had Gram-negative bacterial meningitis and 3 (5%) had Candida meningitis. Gram-negative bacteria were predominant in Group 1 whereas Gram positive bacteria were predominant in Group 2. Transfontanel ultrasonography revealed pathologic findings in 17.5% of patients. The total mortality rate was 2.5%. This large-scale study provides essential information about the etiology, characteristics, and outcome of neonatal bacterial meningitis in Turkey.

Hemimegalencephaly: cranial sonographic findings in neonates

Hemimegalencephaly is a rare neuronal migration disorder characterized by overgrowth of part or all of 1 cerebral hemisphere. Lissencephaly, pachygyria, polymicrogyria, heterotopia, and glial abnormalities are usually noted pathologically in the enlarged hemisphere. We report the sonographic changes associated with hemimegalencephaly in 2 neonates presenting with seizures and correlate these changes with the magnetic resonance imaging findings.

Psychometric testing of an infant risk assessment for prenatal drug exposure

There is growing evidence that prenatal drug exposure results in abnormal structural organization and vascular injury of the fetal brain ( Morrow et al 2001 Morrow C. Bandstra E. Anthony J. Ofir A. Xue L. Reyes M. Influence of prenatal cocaine exposure on full term infant neurobehavioral functioning. Neurotoxicology and Teratology. 2001; 23: 533-544 Crossref PubMed Scopus (36) Google Scholar , Frank et al 1999 Frank D. McCarten K. Robson C. et al. Level of in utero cocaine exposure and neonatal ultrasound findings. Pediatrics. 1999; 104: 1101-1105 Crossref PubMed Scopus (66) Google Scholar , Mantovani and Calamandrei 2001 Mantovani A. Calamandrei G. Delayed developmental effects following prenatal exposure to drugs. Current Pharmocology Research. 2001; 7: 859-880 Crossref PubMed Scopus (32) Google Scholar , Mayes 1994 Mayes L. Neurobiology of prenatal cocaine exposure effect on developing monoamine systems. Infant Mental health Journal. 1994; 15: 122-131 Crossref Scopus (42) Google Scholar , Smith et al 2001 Smith L. Qureshi N. Renslo R. Sinow R. Prenatal cocaine exposure and cranial sonographic findings in preterm infants. Journal of Clinical Ultrasound. 2001; 29: 72-77 Crossref PubMed Scopus (18) Google Scholar , Zuckerman and Brown 1993 Zuckerman B. Brown E. Maternal substance abuse and infant development. in: Zeanah Jr, C. Handbook of infant mental health. The Guilford Press, New York1993: 143-158 Google Scholar ). These drugs also appear to change the activity of neurons by altering the brain’s neurochemistry ( Deutsch et al 1998 Deutsch S. Mastropaolo J. Rosse R. Neurodevelopmental consequences of early exposure to phencyclidine and related drugs. Clinical Neuropharmacology. 1998; 21: 320-332 PubMed Google Scholar , Heller et al 2001 Heller A. Bubula N. Freeney A. Won L. Elevation of fetal dopamine following exposure to methamphetamine in utero. Brain Research and Developing Brain Research. 2001; 130: 139-142 Crossref PubMed Scopus (14) Google Scholar , Won et al 2002 Won L. Bubula N. Heller A. Fetal exposure to methamphetamine in utero stimulates development of serotonergic neurons in three dimensional reaggregate tissue culture. Synapse. 2002; 43: 139-144 Crossref PubMed Scopus (6) Google Scholar , Zachor et al 2000 Zachor D. Moore J. Brezausek C. Theibert A. Percy A. Cocaine inhibits NGF-induced PC12 cells differentiation through D(1)-type dopamine receptors. Brain Research. 2000; 869: 85-97 Crossref PubMed Scopus (45) Google Scholar ). As the mechanisms underlying drug effects are beginning to be understood, their impact on the drug-exposed infant is apparent, including a variety of neurobehaviors not typically seen in other babies. Tremors, irritability, difficulty being consoled, increased startle response, hypertonicity, poor tracking, lethargy, and decreased interactive behavior have all been noted ( American Academy of Pediatrics Committee on Drugs 1998 American Academy of Pediatrics Committee on DrugsNeonatal drug withdrawal (RE9746). Pediatrics. 1998; 101: 1079-1088 Google Scholar , Chasnoff and Griffith 1989 Chasnoff I. Griffith D. Cocaine Clinical studies of pregnancy and the newborn. Annals of the New York Academy of Sciences. 1989; 562: 260-266 Crossref PubMed Scopus (63) Google Scholar , Eyler et al 2001 Eyler F. Behnke M. Garvan C. Woods N. Wobie K. Conlon M. Newborn evaluations of toxicity and withdrawal related to prenatal cocaine exposure. Neurotoxicology and Teratology. 2001; 23: 399-411 Crossref PubMed Scopus (28) Google Scholar , Frank et al 1998 Frank D. Augustyn M. Zuckerman B. Neonatal neurobehavioral and neuroanatomic correlates of prenatal cocaine exposure Problems of dose and confounding. Annals of the New York Academy of Science. 1998; 846: 40-50 Crossref PubMed Scopus (42) Google Scholar , Kosofsky 1998 Kosofsky B. Cocaine-induced alterations in neuro-development. Seminars in Speech and Language. 1998; 19: 109-121 Crossref PubMed Scopus (17) Google Scholar , Lewis 1991 Lewis K.D. Behavioral characteristics of prenatal drug exposed infants using the Lewis Protocol. University of San Francisco, San Francisco, CA1991 Google Scholar , Lewis et al 1989 Lewis K.D. Bennett B. Schmeder N. The care of infants menaced by cocaine abuse. Maternal Child Nursing. 1989; 14: 324-329 Crossref Google Scholar ).

Prenatal cocaine exposure and cranial sonographic findings in preterm infants

Prenatal cocaine exposure and cranial sonographic findings in preterm infants

Prenatal cocaine exposure and cranial sonographic findings in preterm infants.

Prenatal cocaine exposure has been linked with subependymal hemorrhage and the formation of cysts that are detectable on cranial sonography in neonates born at term. We sought to determine if prenatal cocaine exposure increases the incidence of subependymal cysts in preterm infants. We retrospectively reviewed the medical records and cranial sonograms obtained during a 1-year period on 122 premature (< 36 weeks of gestation) infants. Infants were categorized into 1 of 2 groups: those exposed to cocaine and those not exposed to cocaine. Infants were assigned to the cocaine-exposed group if there was a maternal history of cocaine abuse during pregnancy or if maternal or neonatal urine toxicology results were positive at the time of delivery. Five of the 122 infants were excluded from the study because of insufficient medical and drug histories. The incidence of subependymal cysts in the 117 remaining infants was 14% (16 of 117). The incidence of subependymal cysts in infants exposed to cocaine prenatally was 44% (8 of 18) compared with 8% (8 of 99) in the unexposed group (p < 0.01). We found an increased incidence of subependymal cyst formation in preterm infants who were exposed to cocaine prenatally. This result is consistent with results of similar studies in term infants.

Clinical analyses and short-term prognoses of neonates with subependymal cysts

Twenty-one neonates with subependymal cysts detected by neurosonography soon after birth were prospectively examined. The clinical and cranial sonographic findings were evaluated with respect to short-term prognosis. The prognosis was poor in 6 patients with congenital viral infection (4 with cytomegalovirus infection and 2 with rubella infection). Five patients also had neurodevelopmental abnormalities (2 with neonatal epileptic seizures, 2 with chromosomal abnormalities, and 1 with lissencephaly). The remaining 10 patients had normal psychomotor development. The incidence of congenital viral infection was statistically correlated with a poor neurodevelopmental outcome. A correlation did not exist between the short-term prognosis and each of the other clinical factors or cranial sonographic findings. Our evidence suggests that further investigation of possible subependymal cyst etiologies is required during a careful, long-term follow-up period.

Periventricular leukomalacia in the pre-term newborn infant: sonographic and clinical features.

The authors reviewed the cranial sonographic findings in 8 pre-term neonates, each of whom had a clinical history and neurological outcome consistent with periventricular leukomalacia (PVL). Initially, echogenic intraparenchymal lesions were identified in a distinctive distribution at the external angle of the lateral ventricles, radiating anteriorly from the trigone to the foramen of Monro to varying degree. With time, predominantly multiseptate cystic components developed. These sonographic features are different from those of periventricular or intraventricular hemorrhage.

Cranial Sonographic Findings in Myelomeningocele: Value in Predicting Need for and Function of Shunt Treatment

Cranial Sonographic Findings in Myelomeningocele: Value in Predicting Need for and Function of Shunt Treatment

Caffey award: cranial sonographic findings in meningomyelocele.

Children with meningomyeloceles have problems involving several organ systems and often require repeated radiologic examinations. They have multiple cranial defects, particularly the Arnold-Chiari II malformation and associated hydrocephalus. Cranial sonographic findings in 29 patients included hydrocephalus with pointing of the frontal horns, asymmetry of the lateral ventricles, and relative enlargement of the occipital horns compared with the frontal horns. Partial absence of the septum pellucidum, abnormalities of the third ventricle including a prominent massa intermedia, prominent anterior commissure, and prominent suprapineal recess were also seen. A V-shaped tentorium cerebelli was demonstrated on axial scan as well as low position of the tent on coronal scan. The posterior fossa pseudomass was demonstrated. A prominent interhemispheric fissure was also seen in some patients. Sonography is an excellent method for following ventricular size and shunt function since repeated examinations can readily be performed.