Computed tomography of brain in symptomatic birth asphyxia

Twenty five asphyxiated newborns (seventeen term and eight preterm) with mean gestational age of 37 weeks (range 28-48 weeks) and mean birth weight of 2.4 kg (range 0.75 kg to 3.5 kg), respectively, constituted the cases in present study. Normal CT scan was found in five term (29.4%) and two preterm babies (25%). CT abnormalities noted in term babies included hemorrhage (subarachnoid 5.8%, intracerebral 11.6%), hypodensity (mild 23.2%, moderate 11.6% severe 5.8%); hypodensity with hemorrhage 5.8% and cerebral atrophy 5.8%. In the preterm babies abnormalities included intraventricular hemorrhage in 25%, isolated hypodensity in 37.5% and hypodensity with hemorrhage in 12.5% cases. Where as mild hypodensity on CT scan in the absence of hemorrhage or other gross abnormality was indicative of a favourable outcome, moderate to severe hypodensity was indicative of ischemic brain injury and an unfavourable outcome. The presence of intraventricular hemorrhage irrespective of the size of bleed was associated with mortality in all in the present study.