Skip to main content
Log in

Early diagnosis of perinatal cerebral lesions in apparently normal full-term newborns by ultrasound of the brain

  • Diagnostic Neuroradiology
  • Published:
Neuroradiology Aims and scope Submit manuscript

Summary

The brains of 1000 consecutive, clinically normal, full-term neonate without signs of perinatal distress were examined by ultrasound 3 days postpartum. We found 35 cases of intracranial haemorrhage (periventricular, choroid plexus and intraventricular); 34 possible sequelae of bleeding (subependymal and choroid plexus pseudocysts; local dilatation of the lateral ventricles) and 21 morphological aberrations. Most of these 90 abnormalities were checked several times. Four children with intracranial haemorrhage developed symptoms (3 hemipareses, 1 infantile spasm) within a year of birth. No child without sonographic abnormalities has so far been recognized as developing a clinical deficit.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Allan WC, Roveto CA, Sawyer LR, Courtney SE (1980) Sector scan ultrasound imaging through the anterior fontanelle. Am J Dis Child 134:1028–1031

    Google Scholar 

  2. Allan WC, Dransfield DA, Tito AM (1984) Ventricular dilation following periventricular haemorrhage: outcome at age 1 year. Pediatrics 73:158

    Google Scholar 

  3. Babcock DS, Bove KE, Han BK (1982) Intracranial Hemorrhage in Premature Infants: Sonographic-pathologic correlation. AJNR 3:309–317

    Google Scholar 

  4. Barmada MA, Moossy J (1980) The developmental factor in neonatal cerebral vascular lesions. J Neuropathol Exp Neurol 39: 340

    Google Scholar 

  5. Blumhagen JD, Mack (1985) Abnormalities of the neonatal cerebral ventricles. Radiol Clin N Am 23:13

    Google Scholar 

  6. Bowermann RA, Donn SM, Silver TM, Jaffe MH (1984) Natural history of neonatal periventricular/intraventricular haemorrhage and its history; sonographic observations. AJR 143:104–1052

    Google Scholar 

  7. Brand M, Rühe B, Steil ML, Gesche J, Saling E (1984) Die Bedeutung eines Ultraschall-Screenings bei Früh- und Neugeborenen. In: Dudenhausen JW, Saling E (eds) Perinatale Medizin, Bd. X. Thieme, Stuttgart New York

    Google Scholar 

  8. Craig WS (1983) Intracranial haemorrhage in the new-born. A study of diagnosis based upon pathological and clinical findings in 126 cases. Arch Dis Child 13:89–124

    Google Scholar 

  9. Deutsche Schlaganfallforschungsgruppe: Hülser PJ, Bernhart H, Birkner B, Buske A, Epelt B, Felgenhauer K, Fischler M, Hartung J, Herrlinger JD, Hertel G, Huss HJ, Köhler W, Köhne M, Krapf H, Marbach-Kirchner C, Peters Th, Plenio A, Prange H, Schneider E, Scholl D, Schwenk B, Seiler KU, Wissel J, Leitung: HH Kornhuber (1991) Flunarizin beim Schlaganfall, Ergebnisse einer prospektiven randomisierten Plazebo-kontrollierten Doppeltblindstudie. In: Firnhaber W, Dworschak K, Lauer K, Nichtweiß M (eds) Verhandlungen der Deutschen Gesellschaft für Neurologie, 6. Springer, Berlin Heidelberg New York, pp 590–591

    Google Scholar 

  10. Donat JF, Okazaki H, Kleinberg F, Reagan J (1978) Intraventricular haemorrhages in full-term and premature infants. Mayo Clin Proc 53:437–442

    Google Scholar 

  11. Dubowitz LMS, Levene MI, Morante A, Palmer P, Dubowitz V (1981) Neurologic signs in neonatal intraventricular haemorrhage: a correlation with real-time ultrasound. J Pediatr 99:127–133

    Google Scholar 

  12. Fakhry J, Schechter A, Tenner MS, Reale M (1985) Cysts of the choroid plexus in neonates: documentation and review of literature. J. Ultrasound Med 4:561–563

    Google Scholar 

  13. Farruggia S, Babcock DS (1981) The cavum septi pellucidi: its appearance and incidence with cranial ultrasonography in infancy. Radiology 139:147–150

    Google Scholar 

  14. Fawer CL, Calame A, Furrer MT (1985) Neurodevelopmental outcome at 12 months of age related to cerebral ultrasound appearances of high risk preterm infants. Early Hum Dev 11:123–132

    Google Scholar 

  15. Fawer CL, Diebold P, Calame A (1987) Periventricular leucomalacia neurodevelopmental outcome in preterm infants. Arch Dis Child 62:30–36

    Google Scholar 

  16. Fiske CF, Filly RA, Callen PW (1981) The normal choroid plexus: ultrasonographic appearance of the neonatal head. Radiology 141:467–471

    Google Scholar 

  17. Fiske CE, Filly RA, Callen PW (1981) Sonographic measurement of lateral ventricular width in early ventricular dilation. J Clin Ultrasound 9:303–307

    Google Scholar 

  18. Friede RL (ed) (1975) Developmental neuropathology. Springer, New York, pp 44–58

    Google Scholar 

  19. Friede RL (ed) (1989) Developmental neuropathology, 2nd ed. Springer, Berlin Heidelberg New York, pp 44–58

    Google Scholar 

  20. Goodwin L, Quisling RG (1983) The neonatal cisterna magna: ultrasonic evaluation. Radiology 149:691–695

    Google Scholar 

  21. Grant EG (1986) Neurosonography: germinal matrix-related haemorrhage. In: Grant EG (ed) Neurosonography of the preterm neonate. Springer, New York Berlin Heidelberg

    Google Scholar 

  22. Guzzetta F, Shackelford GD, Volpe S, Perlmann JM, Volpe JJ (1986) Periventricular intraparenchymal echodensities in the premature newborn: critical determinant of neurologic outcome. Pediatrics 78:995–1006

    Google Scholar 

  23. Hambleton G, Wigglesworth JS (1976) Origin of intraventricular haemorrhage in preterm neonate. Arch Dis Child 51:651–659

    Google Scholar 

  24. Hayden CK, Shattuck KE, Richardson CJ, Ahrendt DK, House R, Swischuk LE (1985) Subependymal germinal matrix haemorrhage in Full-term neonates. Pediatrics 75:714

    Google Scholar 

  25. Horbar JD, Philip AGS, Lucey JF (1980) Ultrasound scan in neonatal ventriculitis. Lancet 3:976

    Google Scholar 

  26. Hörmann D, Herrmann E, Raue W (1987) Zur Ultraschalldignostik intrakranieller Blutungen bei Frühgebornen. Kinderärztl Praxis 55:9–18

    Google Scholar 

  27. Jensen A, Künzel W, Schuhmacher R, Ringel MR, Reither (1984) Analyse hirnsonographischer Befunde bei klinisch unauffählligen Neugeborenen unter Berücksichtigung von Geburtsmodus, Kardiotokographie, Säure-Basenstatus und klinisch-neurologischer Untersuchung. In: Perinatale Medizin, 11. Deutscher Kongreß für Perinatale Medizin, Berlin, Bd.X, p 320. Thieme, Stuttgart New York

    Google Scholar 

  28. Kim MS, Elyaderani MK (1982) Sonographic diagnosis of cerebroventricular haemorrhage in utero. Radiology 142:479–480

    Google Scholar 

  29. Kleiser B, Van Reempts J, Van Deuren B, Haseldonck M, Borgers M, Horn E, Eßeling K, Widder B, Hornhuber HH (1989) Favourable effect of flunarizine on the recovery from hemiparesis in rats with intracerebral hematomas. Neurosci Lett 103:225–228

    Google Scholar 

  30. Lacey DJ, Terplan K (1982) Intraventricular haemorrhage in full-term neonates. Dev Med Child Neurol 24:332–337

    Google Scholar 

  31. Larroche JC (1972) Sub-ependymal pseudo-cysts in the newborn. Biol Neonate 21:170–183

    Google Scholar 

  32. Larroche JC (1977) Developmental pathology of the neonate. Excerpta Medica, Amsterdam, pp 440–441

    Google Scholar 

  33. Larroche JC (1984) Perinatal brain damage. In: Adams JH, Corsellis AN, Duchen LW (eds) Greenfield's neuropathology, 4th ed. Edward Arnold, Frome London, pp 451–492

    Google Scholar 

  34. Levene MI (1980) Diagnosis of subependymal pseudocyst with cerebral ultrasound. Lancet 26:210–211

    Google Scholar 

  35. Levene MI, Fawer CL, Lamont RF (1982) Risk factors in the development of intracranial haemorrhage in the preterm neonate. Arch Dis Child 54:410–417

    Google Scholar 

  36. Levene MI, De Crespigny LC (1983) Classification of intraventricular haemorrhage. Lancet 19:643

    Google Scholar 

  37. Levene MI, De Vries L (1984) Extension of neonatal intraventricular haemorrhage. Arch Dis Child 59:631–636

    Google Scholar 

  38. Levene MI (1985) Intracranial haemorrhage. In: Levene MI, Williams JL, Fawer C-L (eds) Ultrasound of the infant brain. (Clinics in developmental medicine, no 92) Spastics International Medical Publications/Blackwell, Oxford/Lippincott, Philadelphia, pp 34–48

    Google Scholar 

  39. Lustig-Gillmann I, Young BK, Silverman F, Raghavendra BN, Wan L, Reitz MA, Aleksic S, Greco MA, Snyder JR (1983) Intraventricular haemorrhage: sonographic diagnosis and clinical implications. J Clin Ultrasound 11:277–280

    Google Scholar 

  40. Mack LA, Wright K, Hirsch JH, Alvord EC, Guthrie RD, Shuman WP, Rogers JV, Boldener NF (1981) Intracranial haemorrhage in premature infants: accuracy of sonographic evaluation. AJR 137:245–250

    Google Scholar 

  41. Nelson KB, Ellenberg JH (1979) Neonatal signs as predictors of cerebral palsy. Pediatrics 64:225–232

    Google Scholar 

  42. Palmer P, Dubowitz L, Levene MI, Dubowith V (1982) Developmental and neurological progress of preterm infants with intraventricular haemorrhage and ventricular dilatation. Arch Dis Child 57:748–753

    Google Scholar 

  43. Papile LA, Burstein J, Burstein R, Koffler H (1978) Incidence and evolution of subependymal and intraventricular haemorrhage: a study of infants with birth weights less than 1,500 g. J Pediatr 92:529–534

    Google Scholar 

  44. Pape KE, Wigglesworth JS (1979) Haemorrhage, ischemia and the perinatal brain. (Clinics in developmental medicine, no 69/70). Spastics International Publications/Heinemann, London Lippincott, Philadelphia

    Google Scholar 

  45. Patridge JC, Babcock DS, Steichen JJ, Han BK (1983) Optimal timing for diagnostic cranial ultrasound in low-birthweight infants: detection of intracranial haemorrhage and ventricular dilation. J Pediatr 102:281–287

    Google Scholar 

  46. Poland RL, Slovis TL, Shankaran S (1985) Normal values for ventricular size as determined by real time sonographic techniques. Pediatr Radiol 15:12–24

    Google Scholar 

  47. Raimondi AJ (ed) (1972) Pediatric neuroradiology. Saunders, Philadelphia London Toronto, pp 32–95

    Google Scholar 

  48. Reeder JD, Kaude JV, Setzer ES (1982) Choroid plexus haemorrhage in premature neonates: recognition by sonography. AJNR 3:619–622

    Google Scholar 

  49. Reeder JD (1983) The occipital horn of the lateral ventriceles in premature infants. Eur J Radiol 3:148–150

    Google Scholar 

  50. Rempen A, Feige A, Fiedler K (1986) Häufigkeit von auffälligen Ultraschallbefunden des Gehirns bei klinisch asymptomatischen Neugeborenen. Z Geburtshilfe Perinatol 190:190–195

    Google Scholar 

  51. Rempen A, Feige A (1986) Sonographisch diagnostizierte subependymale-intraventrikuläre Blutungen bei klinisch unauffälligen Neugeborenen und ihre Beziehung zu perinatalen Faktoren Z Geburtshilfe. Perinatae 190:243–249

    Google Scholar 

  52. Rumack CM, Johnson ML (1983) Role of computed tomography and ultrasound in neonatal brain imaging. J Comput Tomogr 7:17–29

    Google Scholar 

  53. Sauerbrei EE, Digney M, Harrison PB, Cooperberg PL (1981) Ultrasonic evaluation of neonatal intracranial haemorrhage and its complications. Radiology 139:677–685

    Google Scholar 

  54. Schumacher R, Reither M, Ringel M, Jensen M (1983) Ergebnisse der Hirnsonographie als Screeningmethode bei Neugeborenen. In: Haller U, Willer L (eds) Diagnostik intrakranieller Blutungen beim Neugeborenen. Springer, Berlin Heidelberg New York, pp 118–129

    Google Scholar 

  55. Shakelford GD, Fulling KH, Glasier CM (1983) Cysts of the subependymal germinal matrix: sonographic demonstration with pathologic correlation. Radiology 149:117–121

    Google Scholar 

  56. Shankaran S, Slovis TL, Bedard MP, Poland RL (1982) Sonographic classification of intracranial haemorrhage. A prognostic indicator of mortality, borbidity, and short-term neurologic outcome. J Pediatr 100:469–475

    Google Scholar 

  57. Shaw C, Alvord E (1969) Cava septi pellucidi et vergae: their normal and pathologic states. Brain 92:213–223

    Google Scholar 

  58. Siva Sibramanian KN (1986) Pathophysiology of germinal matrix-related haemorrhage and ischemia. In: Grant EG (ed) Neurosonography of the pre-term neonate. Springer, New York Berlin Heidelberg, pp 25–32

    Google Scholar 

  59. Slovis TL, Shankaran S (1984) Ultrasound in the evaluation of hypoxic-ischemic injury and intracranial haemorrhage in neonates: the state of art. Pediatr Radiol 14:67–75

    Google Scholar 

  60. Sommer A, Bradel EJ, Hamoudi AB (1974) The cerebro-hepato-renal syndrome (Zellwenger's Syndrom). Biol Neonate 25: 219–229

    Google Scholar 

  61. Volpe JJ (1987) Intracranial haemorrhage. In: Volpe JJ (ed) Neurology of the newborn, 2nd edn (Major problems in clinical pediatrics, vol 22). Saunders, Philadelphia, London, Toronto, pp 300–302

    Google Scholar 

  62. Wigglesworth JS, Pape KE (1978) A integrated model for haemorrhagic and ischemic lesions in the newborn brain. Early Hum Dev 2:179–199

    Google Scholar 

  63. Wigglesworth JS, Pape KE (1980) Pathophysiology of intracranial haemorrhage in the newborn. J Perinat Med 8:119–132

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Heibel, M., Heber, R., Bechinger, D. et al. Early diagnosis of perinatal cerebral lesions in apparently normal full-term newborns by ultrasound of the brain. Neuroradiology 35, 85–91 (1993). https://doi.org/10.1007/BF00593960

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF00593960

Key words

Navigation