Neurosonographic findings and neurodevelopmental outcome in infants of less than 1500 gm

Journal of Korean Society of Medical Ultrasound 1994;13(1): 42-46.

ABSTRACT

The value of routine cranial ultrasound scanning for predicting neurodevelopmental outcome was assessed invery low birthweight infants. Fifty eight infants with birth weight less than 1500gm were serially studied withcranial ultrasound to evaluate intracranial hemorrhage and periventricular echodensity. The severity of hemorrhagewas graded according to the Papile's classification. periventricular echodensity was classified into transientflare, prolonged flare and periventricular cyst. prolonged flare were graded as mild or as moderate to severe.Cyst size was measured by widest diameter as either large(>3mm) or small (<2mm). Neurodevelopmental follow up wasperformed by Vojta's postural reaction for prediction of cerebral palsy. Mortality was 20% in infants with gradeI, 19% in those with grade II, 44% in those with grade III and 67% in those with grade IV intracranial hemorrhage.Mild central coordination disturbance was noted in 1 of 5 infants with grade I intracranial hemorrhage and 5 of 10infants with grade II intracranial hemorrhage. Two of 4 infants with grade III intracranial hemorrhage showedmoderate and severe central coordination disturbance. Two of 3 cases with moderate to severe prolonged flare withsmall cysts revealed mild and moderate central coordination disturbances. One case with moderate to severeprlonged flare with large cysts showed severe central coordination disturbance. Grade III, IV intracranialhemorrhages and moderate to severe prolonged flare with large cysts were the most grave neurosonographic findingfor predicting neurodevelopmental outcome.

Keywords: Infants,newborn,central nervous system