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State of the Art Cranial Ultrasound Imaging in Neonates
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Neonatal frontal lobe: sonographic reference values and suggested clinical use
Liron Borenstein-Levin1,2, Shada Makhoul3, Anat Ilivitzki4,5
1Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel. liron.boren@gmail.com.
Pediatric Research
|October 11, 2019
Summary
Frontal lobe cortico-ventricular thickness (FL-CVT) is a new measure for premature infants with post-hemorrhagic hydrocephalus (PHHC). This measurement can help assess the impact of enlarged ventricles on brain parenchyma and guide treatment decisions.
Area of Science:
- Neonatal Neurology
- Pediatric Neuroimaging
- Developmental Neuroscience
Background:
- Intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHHC) are significant concerns in premature infants.
- Current management relies on ventricular size, neglecting frontal lobe dimensions.
- There is a need for improved assessment tools in PHHC management.
Purpose of the Study:
- To establish normative reference values for sonographic frontal lobe cortico-ventricular thickness (FL-CVT) in a large cohort of infants.
- To assess the potential clinical utility of FL-CVT in evaluating PHHC.
Main Methods:
- Retrospective analysis of normal head ultrasound scans from infants born between 24-40 weeks' gestation.
- Scans performed within the first 4 days of life were evaluated.
- Development of a reference range for FL-CVT based on gestational age.
Main Results:
- FL-CVT demonstrated significant growth with increasing gestational age.
- Infants with PHHC showed a mean 20% loss of FL-CVT.
- Case examples illustrated the impact of ventricular dilatation and drainage on frontal lobe growth.
Conclusions:
- Head ultrasound offers a non-invasive method to measure FL-CVT, a parameter that changes significantly with gestation.
- FL-CVT measurement in premature infants with PHHC can directly assess the impact of hydrocephalus on brain tissue.
- Incorporating FL-CVT into assessments may aid PHHC management and intervention timing.
