Neurosonographic findings in high risk neonates with hypoglycemia

In a prospective study, 28 neonates with hypoglycemia underwent a series of neurosonographic follow-ups. Most of the patients completed a total of 12 scans beginning on the first day of admission and finishing at age of 6 months. One patient died of intracranial hemorrhage, 5 cases had severe neurological sequelae and 22 cases developed normally. The main sonographic findings during early the neonatal stage included: (1) diffuse increase of echogenecity; (2) compressed ventricles; (3) increased periventricular echogenecity and (4) hemorrhage. In late neonatal stage, the abnormal findings were (1) increased periventricular echogenecity; (2) ventricular dilatation and (3) increased gyral pattern. Periventricular cystic leukomalacia and brain atrophy were observed on the late follow-up sonography in those cases with neurological sequelae. Hypoglycemia per se may not account for all the damage in the brain. Treatment of the underlying causes should start as soon as possible. However, early sonographic finding may provide critical information for vigorous treatment of hypoglycemia, while the late scans enable early prediction of poor neurological outcome.