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2.
Indian Pediatr ; 1994 Jul; 31(7): 767-74
Article Dans Anglais | IMSEAR | ID: sea-13964

Résumé

Pattern of neurosonographic (NSG) abnormalities in 150 term newborn infants with hypoxic ischemic encephalopathy (HIE) was studied. Sonographic abnormalities, presumably indicating cerebral edema and or ischemia, were observed in 86% (n = 129) cases. Obliteration of the ventricles occurred as the sole abnormality in 30 (20%) cases. Eighty (53%) patients had diffusely increased echogenicity of the brain parenchyma (DPE) in addition to the compression of the ventricles, sulci and the interhemispheric fissure. Focal parenchymal echodense (FPE) lesions occurred in nine (6%) neonates with HIE. Ten (6.6%) patients, however, had increased periventricular echogenicity (PVE). Two patients, one with focal parenchymal lesions and the other with PVE had obliterated ventricles in addition. Regarding temporal sequence earliest NSG abnormalities were DPE or slit like ventricles that were observed on day-1 itself. Focal or periventricular echogenic lesions, however, made their first appearance on day-3 of life. Twenty one patients had normal scans. Fifty patients with abnormal scans died. None of the infants with normal scans, however, died (p < 0.001). At 4 weeks of age, scans performed in 100 survivors revealed no abnormality in 51 cases. Others showed development of cerebral atrophy (n = 21), multicystic encephalomalacia (n = 2), porencephalic cyst (n = 1), or persistence of PVE without cystic changes (n = 4). The results of this study highlight the diagnostic efficacy of neurosonography in cases of HIE. We suggest that it should be incorporated in the routine evaluation of patients with hypoxic brain injury.


Sujets)
Asphyxie néonatale/imagerie diagnostique , Souffrance cérébrale chronique/imagerie diagnostique , Oedème cérébral/imagerie diagnostique , Encéphalopathie ischémique/imagerie diagnostique , Ventricules cérébraux/imagerie diagnostique , Échoencéphalographie , Femelle , Hypoxie foetale/imagerie diagnostique , Études de suivi , Humains , Nourrisson , Nouveau-né , Maladies du prématuré/imagerie diagnostique , Leucomalacie périventriculaire/imagerie diagnostique , Mâle , Examen neurologique
4.
Indian J Pediatr ; 1993 Jan-Feb; 60(1): 11-8
Article Dans Anglais | IMSEAR | ID: sea-82935

Résumé

This study demonstrates the value of neurosonography in the evaluation of subependymal-intraventricular hemorrhage (SEH-IVH) and its major complications in the premature infant. Real time sector scans were performed on 150 premature neonates within first 24 hours of life (mean, 10 hrs), and then at 48, 72, and 96 hours and thereafter at weekly intervals. The incidence of SEH-IVH was 22% (n = 33). Twenty seven of the 33 infants had small hemorrhages (Grade I & II), 4 infants sustained Grade III hemorrhage and 2 infants had Grade IV hemorrhage. All hemorrhages occurred in the first 96 hours of life; 50% being diagnosed with the first scan. Larger grades of hemorrhages were generally symptomatic while majority of patients with small hemorrhages had no associated symptoms. The infants especially at risk were those less than 32 weeks' gestation (odds ratio, 29 fold) and/or birth-weight < 1200 gms (odds ratio, 6 fold). Three infants developed post hemorrhagic ventriculomegaly which subsided spontaneously in two of them by the age of 4 weeks. One infant progressed to post hemorrhagic hydrocephalus. The mortality in the study group was 11.3% (n = 17) and correlated to the severity of hemorrhage (39% vs 3.4%; hemorrhagic vs non hemorrhagic group, p < 0.001). At least one screening sonogram is essential within first 4 days of life to diagnose SEH-IVH, which may be otherwise clinically silent. Once the hemorrhage is diagnosed, followup evaluations may be done at weekly intervals to detect post-hemorrhagic ventriculomegaly.


Sujets)
Hémorragie cérébrale/complications , Épendyme , Humains , Hydrocéphalie/étiologie , Nouveau-né , Maladies du prématuré/imagerie diagnostique
5.
Indian Pediatr ; 1992 Apr; 29(4): 411-5
Article Dans Anglais | IMSEAR | ID: sea-8022

Résumé

Fifty preterm newborn infants with gestational age of 28-36 weeks were subjected to real time cranial sonography to (a) evaluate the ventricular system and brain parenchyma, (b) determine the incidence of intracranial abnormalities, and (c) to establish the utility and advantages of routine cranial sonography in preterm infants. The lateral ventricular width varied from 6-12 mm (8.67 +/- 1.85 mm) while hemispheric width ranged between 3.68 to 3.95 cm with a mean of 3.84 +/- 0.25 cm. The lateral ventricular ratio ranged from 20.9 to 26.4% and it showed progressive decrease with increasing gestational age. Cavum septum pellucidum was found in 68% of the preterms. Incidental intracranial pathologies were detected in 12% of the preterms screened.


Sujets)
Anthropométrie/méthodes , Encéphalopathies/imagerie diagnostique , Céphalométrie/méthodes , Échoencéphalographie/méthodes , Femelle , Humains , Nouveau-né , Prématuré , Maladies du prématuré/imagerie diagnostique , Mâle , Crâne/imagerie diagnostique
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