[Diagnosis and clinical course of cerebral hemorrhage in infants based on sonography]

Infants of very low birth weights (less than 1500 g) born before the 32nd week of gestation have a high incidence of neonatal intracranial hemorrhage (ICH). Beside perinatal and postnatal asphyxia the main risk factor for ICH is the immaturity of the infant. Mild intracranial hemorrhages resolve within a few weeks. Severe ICH, which were seen in very immature babies before 30 weeks of gestation and with birth-weights below 1250 g had a fatal outcome. The mortality rate in severe ICH was 50%. The infants which survived severe ICH developed posthemorrhagic hydrocephalus (PHH). Using the open fontanelle as an acoustic window gray scale ultrasonography of children's brain is able to visualize ICH and PHH. We suggest early sonografic brain investigation within the first days of life in all prematurely born infants with perinatal asphyxia. Infants with severe ICH should have weekly sonografic controls, to detect PHH as soon as possible.