Detection of neonatal intracranial hemorrhage utilizing real-time and static ultrasound

Accurate assessment of neonatal brain anatomy and pathology can now be obtained with commercially available ultrasound equipment. Intracranial hemorrhage (ICH) has a 50% to 60% incidence in premature infants under 32 wk gestational age and is felt to be one of the leading causes of neonatal morbidity and mortality. Computerized tomography (CT) has been the standard for detecting ICH; this study demonstrates that ultrasound is equally accurate and sensitive. Real-time examination through the anterior fontanelle resulted in 100% accuracy when compared with CT in a prospective study. Compound axial scans through the parietal bone were not as accurate, with a sensitivity of 91% and a specificity of 85%. If available, good quality real-time, transfontanelle sector ultrasound should be the screening procedure of choice for detecting and following intracranial hemorrhage in the high-risk premature infant.