Neonatal Intracranial Ischemia and Hemorrhage : Role of Cranial Sonography and CT Scanning

Overview

Journal J Korean Neurosurg Soc

Date 2010 Mar 13

PMID 20224705

Citations 2

Authors

Imran Ahmad Khan

Shagufta Wahab

Rizwan Ahmad Khan

Ekram Ullah

Manazir Ali

Affiliations

Soon will be listed here.

Abstract

Objective: To evaluate the role of cranial sonography and computed tomography in the diagnosis of neonatal intracranial hemorrhage and hypoxic-ischemic injury in an Indian set-up.

Methods: The study included 100 neonates who underwent cranial sonography and computed tomography (CT) in the first month of life for suspected intracranial ischemia and hemorrhage. Two observers rated the images for possible intracranial lesions and a kappa statistic for interobserver agreement was calculated.

Results: There was no significant difference in the kappa values of CT and ultrasonography (USG) for the diagnosis of germinal matrix hemorrhage/intraventricular hemorrhage (GMH/IVH) and periventricular leucomalacia (PVL) and both showed good interobserver agreement. USG, however detected more cases of GMH/IVH (24 cases) and PVL (19) cases than CT (22 cases and 16 cases of IVH and PVL, respectively). CT had significantly better interobserver agreement for the diagnosis of hypoxic ischemic injury (HII) in term infants and also detected more cases (33) as compared to USG (18). CT also detected 6 cases of extraaxial hemorrhages as compared to 1 detected by USG.

Conclusion: USG is better modality for imaging preterm neonates with suspected IVH or PVL. However, USG is unreliable in the imaging of term newborns with suspected HII where CT or magnetic resonance image scan is a better modality.

Citing Articles

Spectrum of Brain Imaging with 3T MRI for Infants with History of Perinatal Hypoxia and their Comparison with 128 Slice NCCT Images.

Dwivedi A, Dakua A, Agarwal M, Singh S, Choudhury B, Chaubey D J Pharm Bioallied Sci. 2025; 16(Suppl 5):S4344-S4348.

PMID: 40061779 PMC: 11888691. DOI: 10.4103/jpbs.jpbs_451_24.

Posterior Fossa Hemorrhage in a Term Neonate with Hemophilia A.

Tsai P, Chen H, Ho C, Chiu N J Med Ultrasound. 2018; 26(1):56-58.

PMID: 30065516 PMC: 6029183. DOI: 10.4103/JMU.JMU_10_18.

Cinegraphic versus Combined Static and Cinegraphic Imaging for Initial Cranial Ultrasound Screening in Premature Infants.

ODell M, Cassady C, Logsdon G, Varich L Pediatr Radiol. 2015; 45(11):1706-11.

PMID: 26008871 DOI: 10.1007/s00247-015-3382-0.

References

Perlman J, Rollins N . Surveillance protocol for the detection of intracranial abnormalities in premature neonates. Arch Pediatr Adolesc Med. 2000; 154(8):822-6. DOI: 10.1001/archpedi.154.8.822. View

Blankenberg F, Norbash A, Lane B, Stevenson D, Bracci P, Enzmann D . Neonatal intracranial ischemia and hemorrhage: diagnosis with US, CT, and MR imaging. Radiology. 1996; 199(1):253-9. DOI: 10.1148/radiology.199.1.8633155. View

Boal D, Watterberg K, Miles S, Gifford K . Optimal cost-effective timing of cranial ultrasound screening in low-birth-weight infants. Pediatr Radiol. 1995; 25(6):425-8. DOI: 10.1007/BF02019054. View

Ment L, Bada H, Barnes P, Grant P, Hirtz D, Papile L . Practice parameter: neuroimaging of the neonate: report of the Quality Standards Subcommittee of the American Academy of Neurology and the Practice Committee of the Child Neurology Society. Neurology. 2002; 58(12):1726-38. DOI: 10.1212/wnl.58.12.1726. View

Ayyapan C, Rajeshwari P, Edwin N . Clinical and computerised tomography evaluation of term neonates with perinatal asphyxia. Indian Pediatr. 2000; 36(2):174-7. View

Vergani P, Locatelli A, DOria V, Assi F, Paterlini G, Pezzullo J . Intraventricular hemorrhage and periventricular leukomalacia in preterm infants. Obstet Gynecol. 2004; 104(2):225-31. DOI: 10.1097/01.AOG.0000130838.02410.b7. View

Donker D, Hasman A, van Geijn H . Interpretation of low kappa values. Int J Biomed Comput. 1993; 33(1):55-64. DOI: 10.1016/0020-7101(93)90059-f. View

Viera A, Garrett J . Understanding interobserver agreement: the kappa statistic. Fam Med. 2005; 37(5):360-3. View

Kazam E, Rudelli R, Monte W, Rubenstein W, Ramirez de Arellano E, Kairam R . Sonographic diagnosis of cisternal subarachnoid hemorrhage in the premature infant. AJNR Am J Neuroradiol. 1994; 15(6):1009-20. PMC: 8333480. View

10.

Stark J, Seibert J . Cerebral artery Doppler ultrasonography for prediction of outcome after perinatal asphyxia. J Ultrasound Med. 1994; 13(8):595-600. DOI: 10.7863/jum.1994.13.8.595. View

11.

Shah R, Gupta A, Rehani M, Pandey A, Mukhopadhyay S . Effect of reduction in tube current on reader confidence in paediatric computed tomography. Clin Radiol. 2005; 60(2):224-31. DOI: 10.1016/j.crad.2004.08.011. View

12.

Mack L, Wright K, Hirsch J, Alvord E, Guthrie R, Shuman W . Intracranial hemorrhage in premature infants: accuracy in sonographic evaluation. AJR Am J Roentgenol. 1981; 137(2):245-50. DOI: 10.2214/ajr.137.2.245. View

13.

Blankenberg F, Loh N, Bracci P, DArceuil H, Rhine W, Norbash A . Sonography, CT, and MR imaging: a prospective comparison of neonates with suspected intracranial ischemia and hemorrhage. AJNR Am J Neuroradiol. 2000; 21(1):213-8. PMC: 7976363. View

14.

Babcock D, Ball Jr W . Postasphyxial encephalopathy in full-term infants: ultrasound diagnosis. Radiology. 1983; 148(2):417-23. DOI: 10.1148/radiology.148.2.6867334. View

15.

BURSTEIN J, Papile L, Burstein R . Intraventricular hemorrhage and hydrocephalus in premature newborns: a prospective study with CT. AJR Am J Roentgenol. 1979; 132(4):631-5. DOI: 10.2214/ajr.132.4.631. View