J Korean Neurosurg Soc.  2010 Feb;47(2):89-94. 10.3340/jkns.2010.47.2.89.

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

• Khan IA
• Wahab S
• Khan RA
• Ullah E
• Ali M

• KMID: 1453136
• DOI: http://doi.org/10.3340/jkns.2010.47.2.89

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.

Keyword

Hypoxic ischemic injury; Ultrasonography; CT-scan

MeSH Terms

Hemorrhage
Humans
Infant
Infant, Newborn
Intracranial Hemorrhages
Ischemia
Leukomalacia, Periventricular
Magnetic Resonance Spectroscopy