Evaluation of Transcranial Ultrasound In Detection Of Neonatal Periventricular-Intraventricular Hemorrhage

Abstract

Periventricular–intraventricular hemorrhage (PVH-IVH) is the most common variety of neonatal intracranial hemorrhage and is characteristic of the premature infant. Commonly cited clinical factors that alter the risk for severe IVH, including mode of delivery, pregnancy induced hypertension, premature and/or prolonged rupture of membranes, maternal fever ,maternal bleeding ,prenatal steroid administration, 1minute and 5 minute apgar scores, surfactant therapy, presence of refractory hypotension ,evidence of early onset culture-proven sepsis ,use of high frequency ventilation ,presence of pneumothorax and hemodynamically significant patent ductus artriosus. Transcranial ultrasound is used to evaluate the brain in newborn and infants. The technique is done through the anterior fontanelle in coronal and sagittal planes includes all the brain parts. The technique is readily applied at bedside, does not involve ionizing radiation, is cost effective and can used sequentially. Ultrasound scan has displaced CT as the principal diagnostic technique, not only because of equivalent resolution for identification of the hemorrhage but also because CT has the disadvantages of requiring the sick premature infant to be transported and of exposing the brain and eyes to ionizing radiation. Ultrasound scan is effective in identification of all degrees of severity of IVH from isolated germinal matrix hemorrhage to major degrees and The accuracy of US imaging in the diagnosis of PVH-IVH is reported to be approximately 90 % which is comparable to diagnosis by CT, thus ultrasound imaging has now become the imaging modality of choice for the detection and screening for the PVH-IVH.