Cranial ultrasound abnormalities in full term infants in a postnatal ward: outcome at 12 and 18 months
Leena Haataja, Eugenio Mercuri, Frances Cowan, Lilly Dubowitz
Department of
Paediatrics and Neonatal Medicine, Imperial College School of Medicine,
Hammersmith Hospital, Du Cane Road, London W12 0HS, UK
Correspondence to: Dr Dubowitz
Accepted 1
August 1999
OBJECTIVE
To
investigate whether cranial ultrasound abnormalities found in low risk
full term infants had any influence on neurodevelopmental outcome.
METHODSFor 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.
RESULTSNone 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.
CONCLUSIONIncidental
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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Key messages
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Keywords: ultrasound; neurological assessment; intraventricular haemorrhage; brain; white matter; development
© 2000 by Archives of Disease in Childhood
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