Detection of neonatal intracranial hemorrhage utilizing real-time and static ultrasound

Abstract

Accurate assessment of neonatal brain anatomy and pathology can now be obtained with commercially available ultrasound equipment. Intracranial hemorrhage (ICH) has a 50-60% incidence in premature infants < 32 wk gestational age and is felt to be one of the leading causes of neonatal morbidity and mortality. Computerized tomography (CT) has been the standard for detecting ICH; here, ultrasound is shown to be equally accurate and sensitive. Real-time examination through the anterior fontanelle resulted in 100% accuracy when compared to CT in a prospective study. Compound axial scans through the parietal bone were not as accurate, with a sensitivity of 91% and a specificity of 85%. If available, good quality real-time, transfontanelle sector ultrasound should be the screening procedure of choice for detecting and following intracranial hemorrhage in the high-risk premature infant.