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Intracranial hemorrhage in premature infants: sonographic-pathologic correlation
AJNR. American Journal of Neuroradiology
|May 1, 1982
Summary
Cranial sonography accurately identifies most intracranial hemorrhages in premature infants, correlating well with autopsy findings for subependymal, intraventricular, and intraparenchymal bleeds. However, sonographic prominent subarachnoid spaces may be a normal variant.
Area of Science:
- Neonatal Neurology
- Pediatric Radiology
- Neuroscience
Background:
- Spontaneous intracranial hemorrhage (SIH) is a frequent central nervous system abnormality in premature infants.
- Early detection and accurate characterization of SIH are crucial for managing affected neonates.
Purpose of the Study:
- To correlate cranial sonographic findings with pathologic findings in autopsied premature infants.
- To evaluate the diagnostic accuracy of sonography in detecting various types of intracranial hemorrhage and hydrocephalus.
Main Methods:
- Correlation of cranial sonographic imaging with post-mortem pathological examination.
- Analysis of 25 autopsied premature infants with documented intracranial abnormalities.
Main Results:
- Sonography accurately documented the presence and size of subependymal, intraventricular, and intraparenchymal hemorrhages.
- Cerebellar, choroid plexus, and cortical hemorrhages were also recognized by sonography.
- Sonography showed good correlation with the presence and degree of hydrocephalus; prominent subarachnoid spaces on sonography showed poor correlation with autopsy findings and may represent a normal variant.
Conclusions:
- Cranial sonography is a valuable tool for diagnosing intracranial hemorrhage and hydrocephalus in premature infants.
- Sonographic findings of prominent subarachnoid spaces should be interpreted cautiously as they may not indicate hemorrhage.
- Sonography can detect diffuse brain atrophy with hydrocephalus exvacuo, though early anoxic brain damage without hemorrhage may not be diagnosed.