DIAGNOSIS AND FOLLOW-UP OF INTRAVENTRICULAR AND INTRA-CEREBRAL HEMORRHAGES BY ULTRASOUND STUDIES OF INFANTS BRAIN THROUGH THE FONTANELLES AND SUTURES

Abstract

A technique to diagnose subependymal hemorrhage (SEH), intraventricular hemorrhage (IVH), intracerebral hemorrhage and posthemorrhage hydrocephalus in tiny infants, using real time ultrasound studies of the brain ventricular system, is described. This is a bedside technique that visualizes the brain through the fontanelles and the sutures, in 3 planes: coronal, sagittal and horizontal. Excellent visualization of the ventricular system, caudate nuclei, the thalamus, the choroid plexus, the corpus callosum and the foramen of Monro is obtained. This method has good definition using high frequency transducers since there is no bone interference. The ultrasound diagnosis correlated well with computed tomography (CT) and with direct pathologic studies. This technique was more sensitive in diagnosing small IVH/SEH and organized clots than were CT studies. IVH/SEH were found in 90% of 113 infants .ltoreq. 34 wk of gestation; 49% of the hemorrhages were large and 41% were small. Most hemorrhages were found in the 1st scan usually shortly after birth. Premature infants (21) who never had perinatal asphyxia or respiratory distress syndrome had IVH/SEH. The hemorrhages were followed until disappearance, usually in 1-3 mo. in cases of large hemorrhages.