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Prevalence of "compressed" and asymmetric lateral ventricles in healthy full-term neonates: sonographic study
Insights
This study on healthy full-term infants found that "compressed" lateral ventricles are common shortly after birth and not indicative of cerebral edema. Asymmetric ventricular size may also be normal, but unexpected intracranial hemorrhage can occur.
Area of Science:
- Neonatal Neurology
- Pediatric Radiology
- Neuroimaging
Background:
- Premature infant brain sonography standards for ventricular size are established.
- Applicability of these standards to healthy full-term infants remains uncertain.
Purpose of the Study:
- To evaluate ventricular size and morphology in healthy full-term infants using real-time sonography.
- To determine if established premature infant standards apply to full-term neonates.
Main Methods:
- Real-time sonography was performed through the anterior fontanelle on 53 healthy full-term infants within the first six days of life.
- Ventricular size (symmetric vs. asymmetric) and cerebrospinal fluid (CSF) presence were assessed.
Main Results:
- Nine infants presented with asymmetric lateral ventricles; three showed unexpected intracranial abnormalities (hemorrhage or cyst).
- Forty-four infants had symmetric ventricles, with 36 exhibiting minimal or no cerebrospinal fluid ("compressed" ventricles).
- Vaginal delivery showed a significant association with these "compressed" lateral ventricles.
Conclusions:
- Healthy full-term infants may harbor unsuspected intracranial hemorrhage.
- Asymmetric ventricular size can be a normal finding in neonates.
- "Compressed" lateral ventricles are common in healthy newborns and should not be misdiagnosed as cerebral edema.
Abstract:
The premature infant brain has been thoroughly studied by sonography, and normal standards for ventricular size have been established. Whether these apply to normal full-term infants is uncertain. Fifty-three healthy full-term infants were electively examined by real-time sonography through the anterior fontanelle on the first to sixth days of life. Nine had asymmetric lateral ventricles; two of these had unexpected evidence of intracranial hemorrhage, while a third had a ventricular cyst. Forty-four infants had symmetric ventricles, but in 36 the ventricles had little or no cerebrospinal fluid. Vaginal delivery had a statistically significant association with these "compressed' lateral ventricles. This study indicates that seemingly healthy infants may have unsuspected intracranial hemorrhage, that asymmetric ventricular size may be normal, and that shortly after birth most healthy infants have "compressed" lateral ventricles that should not be interpreted as cerebral edema.