Clinical guidelines - INTRACRANIAL ULTRASONOGRAPHY IN DIAGNOSTICS OF PERINATAL BRAIN LESIONS

We present an overview of intracranial ultrasonography in neonates and infants, particularly in the diagnostics of perinatal brain haemorrhagic and hypoxic-ischemic lesions, focal vacular lesions in preterm and term neonates, as well as the follow up of structural reorganization. The pathogenesis of all mentioned lesions is related to perinatal risk factors, leading to disturbed perfusion of the brain (hypo/hyperperfusion), precipitated by poor autoregulation of cerebral blood flow and immaturity of cerebral vessels.
The grading system, ultrasonographic diagnostic criteria and the timing of the diagnostics for both periventricular and hypoxic ischemic lesions are considered.
The type, size and localisation of perinatal lesions predict the prognosis of neurodevelopmental outcome. Peri-intraventricular haemorrhages of lower grade have a favourable prognosis; wheras neurodevelopmental disorders are related to a more severe grade of intraventricular haemmorhages and hypoxic ischemic lesions. Periventricular leukomalacia is the most common type of neurodevelopmental disorders, whereby the cystic form is in most cases related to cerebral palsy.

Keywords
Intracranial ultrasonography, perinatal brain lesion, periintraventricular hemorrhage, hypoxic-ischaemic brain lesion, prognosis of neurodevelopmental outcome