NEUROSONOGRAPHY SPECTRUM OF HYPOXIC ISCHEMIC ENCEPHALOPATHY

Abstract

Introduction: Neonatal hypoxic-ischemic encephalopathy (HIE) is a very catastrophic condition that may result in severe neurologic deficits or even death. Neuroimaging with transcranial ultrasound (US) is a valuable tool in the workup of patients with HIE. The pattern of brain injury depends on the severity and duration of hypoxia and degree of brain maturation.¹

Aim: To study imaging spectrum of various stages of HIE

Objective: To determine severity of HIE on basis of Neuro-sonography.

Settings and Design: The study was conducted at J K Lone Paediatric hospital attached to SMS hospital. It is a Prospective study.

Materials and Method: Pre term neonates having some history of hypoxia antenatally or perinatally like placental abruption, low Apgar at delivery, seizures coming to JK lone Paediatric Hospital attached to SMS hospital referred to Dept of Radiodiagnosis for evaluation of HIE were scanned using Transcranial ultrasound it included grayscale on Hitachi machine.

Results- Different grades of HIE changes were witnessed. Out of 33 cases:

5 neonates were sonographically normal, 3 showed grade 1 GMH, 3 showed grade 2 GMH, 4 showed grade 3 GMH and 4 showed grade 4 . 3 neonates showed grade 1 PVL, 2 grade 2 PVL, 4 showed grade 3 PVL, 5 showed grade 4 PVL. In doppler findings of ACA, it was noted the RI (resistive index) was on the higher side.

Conclusion: Neurosonography and doppler is very helpful non-invasive tool to detect early changes of HIE and assess severity and progression of hypoxic brain injury.    

Keywords: HIE, hypoxic brain injury, germinal matrix haemorrhage and periventricular leucomalacia