Abstract
OBJECTIVE—To investigate whether cranial ultrasound abnormalities found in low risk full term infants had any influence on neurodevelopmental outcome. METHODS—For 103 infants who had a neurological assessment, a cranial ultrasound examination, and for whom antenatal and perinatal data were collected within 48 hours of delivery, neurodevelopmental status was evaluated at 12 and 18 months. The results of a scored neurological examination and the Griffiths mental developmental scale were correlated with the presence and type of ultrasound abnormality found in the neonatal period. RESULTS—None of the infants with ultrasound abnormalities showed any signs of cerebral palsy or severe developmental delay. There was also no significant difference between the overall neurological and neurodevelopmental scores of the infants with normal and abnormal ultrasound findings. However, when the individual subscales of the Griffiths test were analysed, all infants with bulky choroid or intraventricular haemorrhage had normal scores in all subscales, four of eight with periventricular white matter lesions had low scores on the locomotor subscale, and three of five with asymmetrical ventricles had low scores on the performance subscale. The presence of adverse antenatal and perinatal factors did not affect the outcome in this group. CONCLUSION—Incidental ultrasound abnormality in full term neonates, in particular intraventricular haemorrhage, although common, appear to have a good prognosis. Longer follow up studies are needed to see whether some of these infants, in particular those with white matter lesions, develop dyspraxia or other minor neurological impairments at school age.
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Selected References
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- De Vries L. S., Regev R., Pennock J. M., Wigglesworth J. S., Dubowitz L. M. Ultrasound evolution and later outcome of infants with periventricular densities. Early Hum Dev. 1988 Mar;16(2-3):225–233. doi: 10.1016/0378-3782(88)90103-x. [DOI] [PubMed] [Google Scholar]
- De Vries L. S., Smet M., Goemans N., Wilms G., Devlieger H., Casaer P. Unilateral thalamic haemorrhage in the pre-term and full-term newborn. Neuropediatrics. 1992 Jun;23(3):153–156. doi: 10.1055/s-2008-1071332. [DOI] [PubMed] [Google Scholar]
- Dubowitz L. M., Dubowitz V., Palmer P. G., Miller G., Fawer C. L., Levene M. I. Correlation of neurologic assessment in the preterm newborn infant with outcome at 1 year. J Pediatr. 1984 Sep;105(3):452–456. doi: 10.1016/s0022-3476(84)80028-1. [DOI] [PubMed] [Google Scholar]
- Eken P., Jansen G. H., Groenendaal F., Rademaker K. J., de Vries L. S. Intracranial lesions in the fullterm infant with hypoxic ischaemic encephalopathy: ultrasound and autopsy correlation. Neuropediatrics. 1994 Dec;25(6):301–307. doi: 10.1055/s-2008-1073044. [DOI] [PubMed] [Google Scholar]
- Garg B. P., DeMyer W. E. Ischemic thalamic infarction in children: clinical presentation, etiology, and outcome. Pediatr Neurol. 1995 Jul;13(1):46–49. doi: 10.1016/0887-8994(95)00108-r. [DOI] [PubMed] [Google Scholar]
- Guekos-Thoeni U., Boltshauser E., Willi U. V. Intraventricular haemorrhage in full-term neonates. Dev Med Child Neurol. 1982 Oct;24(5):704–705. doi: 10.1111/j.1469-8749.1982.tb13686.x. [DOI] [PubMed] [Google Scholar]
- Guzzetta F., Shackelford G. D., Volpe S., Perlman J. M., Volpe J. J. Periventricular intraparenchymal echodensities in the premature newborn: critical determinant of neurologic outcome. Pediatrics. 1986 Dec;78(6):995–1006. [PubMed] [Google Scholar]
- Hayden C. K., Jr, Shattuck K. E., Richardson C. J., Ahrendt D. K., House R., Swischuk L. E. Subependymal germinal matrix hemorrhage in full-term neonates. Pediatrics. 1985 Apr;75(4):714–718. [PubMed] [Google Scholar]
- Heibel M., Heber R., Bechinger D., Kornhuber H. H. Early diagnosis of perinatal cerebral lesions in apparently normal full-term newborns by ultrasound of the brain. Neuroradiology. 1993;35(2):85–91. doi: 10.1007/BF00593960. [DOI] [PubMed] [Google Scholar]
- Hope P. L., Gould S. J., Howard S., Hamilton P. A., Costello A. M., Reynolds E. O. Precision of ultrasound diagnosis of pathologically verified lesions in the brains of very preterm infants. Dev Med Child Neurol. 1988 Aug;30(4):457–471. doi: 10.1111/j.1469-8749.1988.tb04773.x. [DOI] [PubMed] [Google Scholar]
- Mercuri E., Dubowitz L., Brown S. P., Cowan F. Incidence of cranial ultrasound abnormalities in apparently well neonates on a postnatal ward: correlation with antenatal and perinatal factors and neurological status. Arch Dis Child Fetal Neonatal Ed. 1998 Nov;79(3):F185–F189. doi: 10.1136/fn.79.3.f185. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Nelson K. B., Dambrosia J. M., Grether J. K., Phillips T. M. Neonatal cytokines and coagulation factors in children with cerebral palsy. Ann Neurol. 1998 Oct;44(4):665–675. doi: 10.1002/ana.410440413. [DOI] [PubMed] [Google Scholar]
- Pape K. E., Blackwell R. J., Cusick G., Sherwood A., Houang M. T., Thorburn R. J., Reynolds E. O. Ultrasound detection of brain damage in preterm infants. Lancet. 1979 Jun 16;1(8129):1261–1264. doi: 10.1016/s0140-6736(79)92227-x. [DOI] [PubMed] [Google Scholar]
- Papile L. A., Munsick-Bruno G., Schaefer A. Relationship of cerebral intraventricular hemorrhage and early childhood neurologic handicaps. J Pediatr. 1983 Aug;103(2):273–277. doi: 10.1016/s0022-3476(83)80366-7. [DOI] [PubMed] [Google Scholar]
- Scher M. S., Wright F. S., Lockman L. A., Thompson T. R. Intraventricular hemorrhage in the full-term neonate. Arch Neurol. 1982 Dec;39(12):769–772. doi: 10.1001/archneur.1982.00510240031008. [DOI] [PubMed] [Google Scholar]
- Shen E. Y., Huang F. Y. Subependymal cysts in normal neonates. Arch Dis Child. 1985 Nov;60(11):1072–1074. doi: 10.1136/adc.60.11.1072. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Stewart A. L., Thorburn R. J., Hope P. L., Goldsmith M., Lipscomb A. P., Reynolds E. O. Ultrasound appearance of the brain in very preterm infants and neurodevelopmental outcome at 18 months of age. Arch Dis Child. 1983 Aug;58(8):598–604. doi: 10.1136/adc.58.8.598. [DOI] [PMC free article] [PubMed] [Google Scholar]
- de Vries L. S., Dubowitz L. M., Dubowitz V., Kaiser A., Lary S., Silverman M., Whitelaw A., Wigglesworth J. S. Predictive value of cranial ultrasound in the newborn baby: a reappraisal. Lancet. 1985 Jul 20;2(8447):137–140. doi: 10.1016/s0140-6736(85)90237-5. [DOI] [PubMed] [Google Scholar]