Mohammad Mahbub Hossain
One of the problems of neonatal neurology is the lack of clinical signs associated with the development of cerebral lesions in the newborn infants. This has allowed gross intracranial lesions to go undiagnosed in the neonatal period and may be responsible for the persisting confusion over the causes of cerebral palsy. The neurological and developmental handicap is related to two major neurological insults; Periventricular Leucomalacia (PVL) and Intra-Ventricular Hemorrhage (IVH). Spontaneous hemorrhage in and around the cerebral ventricles is a phenomenon that occurs in premature neonates; is now being increasingly observed in high-risk term neonates. Ultrasonography (USG), Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are being routinely used to screen the neonate. This study was aimed to establish the diagnostic usefulness of cranial ultrasonography in the detection of neonatal intracranial hemorrhage compared to CT scan. 70 neonates were included in this study of which 50 (71 %) were preterm and 20 (29 %) were term neonates with a male predominance (86%). On Cranial Ultrasonography 44(62.8%) neonates had intracranial hemorrhage among them 35 (79.5%) were preterm and 09 (20.5%) were term neonates. On CT scan 42(60%) neonates had intracranial hemorrhage, of which 31 (74%) were preterm and 11 (26%) were term neonate. Compared to CT findings the cranial-ultrasonography diagnosis yielded a Sensitivity of 92.1%, Specificity of 80.9%. PPV of 92.1%, NPV of 89.4% and accuracy of 91.4%. The experience gained in this study would suggest that cranial-ultrasonography can be employed in screening the neonates for intracranial hemorrhage.
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