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• W2417825873 abstract "To determine the accuracy of ultrasound scanning (RTBS) for the detection of intracranial hemorrhage (ICH) in newborn infants, we analyzed the results of 357 scans in 176 selected neonates born at Los Angeles County/University of Southern California Medical Center. RTBS was performed in the immediate neonatal period (1 to 3 days). Confirmation of RTBS was available from computerized tomography (CT) scanning, lumbar puncture (LP), or postmortem examination in 60% of the positive findings and 20% of the negative findings. RTBS appeared to be as accurate in diagnosing ICH as was CT scanning, and was far more convenient to use. RTBS permitted localization of ICH and determination of the type of ICH (subarachnoid, intraventricular, or intracerebral), site of origin (germinal matrix, choroid plexus), and uniform selective and asymmetrical ventricular dilatations. The overall incidence of ICH in this selected population was 72%, with the risk decreasing with advancing gestational age. ICH was found in 90% of those babies less than 33 weeks, and in 45% of babies more than 36 weeks. Breech presentation during labor was invariably associated with ICH irrespective of the route of delivery. Furthermore, there was no apparent benefit of cesarean section over vaginal delivery in any age group in which cesarean section was undertaken after the onset of labor. Of the 20 babies who were thought to have undergone traumatic delivery, 16 (90%) were found to have ICH. Follow-up scans (up to 38 days of life) revealed that selective and asymmetrical ventricular dilatations were a far more common sequel to intraventricular hemorrhage (IVH) than was uniform ventricular dilatation. Of the 78 term fetuses, 38 were found to have ICH, half of whom were asymptomatic at the time of RTBS. Compression of the thalamus/brain stem on RTBS was invariably associated with neurological symptoms in the newborn infant. On the other hand, neurological symptoms were present in only 20% of those in whom compression of the thalamus/brain stem was absent. The percentage of symptomatic babies with ICH appeared to decrease with increasing gestational age in the preterm infant. A continuation of this decreasing trend was not found in the term infants who were studied. The percentage of symptomatic babies with subarachnoid hemorrhage (SAH) alone appeared to increase with advancing gestational age. In consideration of the frequency of positive findings in asymptomatic infants and the promising correlations between RTBS findings, obstetric/ neonatal practices, and neurological symptoms in newborn infants, routine scanning may be necessary for an understanding of the long-term consequences of ICH. Similarly, these results suggest that ICH, as determined on RTBS, may represent another endpoint with which to assess the quality of perinatal care. To determine the accuracy of ultrasound scanning (RTBS) for the detection of intracranial hemorrhage (ICH) in newborn infants, we analyzed the results of 357 scans in 176 selected neonates born at Los Angeles County/University of Southern California Medical Center. RTBS was performed in the immediate neonatal period (1 to 3 days). Confirmation of RTBS was available from computerized tomography (CT) scanning, lumbar puncture (LP), or postmortem examination in 60% of the positive findings and 20% of the negative findings. RTBS appeared to be as accurate in diagnosing ICH as was CT scanning, and was far more convenient to use. RTBS permitted localization of ICH and determination of the type of ICH (subarachnoid, intraventricular, or intracerebral), site of origin (germinal matrix, choroid plexus), and uniform selective and asymmetrical ventricular dilatations. The overall incidence of ICH in this selected population was 72%, with the risk decreasing with advancing gestational age. ICH was found in 90% of those babies less than 33 weeks, and in 45% of babies more than 36 weeks. Breech presentation during labor was invariably associated with ICH irrespective of the route of delivery. Furthermore, there was no apparent benefit of cesarean section over vaginal delivery in any age group in which cesarean section was undertaken after the onset of labor. Of the 20 babies who were thought to have undergone traumatic delivery, 16 (90%) were found to have ICH. Follow-up scans (up to 38 days of life) revealed that selective and asymmetrical ventricular dilatations were a far more common sequel to intraventricular hemorrhage (IVH) than was uniform ventricular dilatation. Of the 78 term fetuses, 38 were found to have ICH, half of whom were asymptomatic at the time of RTBS. Compression of the thalamus/brain stem on RTBS was invariably associated with neurological symptoms in the newborn infant. On the other hand, neurological symptoms were present in only 20% of those in whom compression of the thalamus/brain stem was absent. The percentage of symptomatic babies with ICH appeared to decrease with increasing gestational age in the preterm infant. A continuation of this decreasing trend was not found in the term infants who were studied. The percentage of symptomatic babies with subarachnoid hemorrhage (SAH) alone appeared to increase with advancing gestational age. In consideration of the frequency of positive findings in asymptomatic infants and the promising correlations between RTBS findings, obstetric/ neonatal practices, and neurological symptoms in newborn infants, routine scanning may be necessary for an understanding of the long-term consequences of ICH. Similarly, these results suggest that ICH, as determined on RTBS, may represent another endpoint with which to assess the quality of perinatal care." @default.
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• W2417825873 date "1982-04-01" @default.
• W2417825873 modified "2023-09-26" @default.
• W2417825873 title "Real-time B scanning in the diagnosis of neonatal intracranial hemorrhage" @default.
• W2417825873 cites W1559998581 @default.
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• W2417825873 doi "https://doi.org/10.1016/s0002-9378(16)32531-5" @default.
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