Congenital hypothyroidism: the clinical profile of affected newborns identified by the Newborn Screening Program of the State of Minas Gerais, Brazil.
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Transfontanelle ultrasonography of infant brain: analysis of findings in 114 patients in Benin City, Nigeria.
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OBJECTIVES: To analyse the pattern of findings in sonographic examination of infant brains. SETTING: Radiology Department of a University Teaching Hospital. MATERIALS AND METHODS: The ultrasound request cards, reports and case notes of 114 consecutive term infants who underwent transfontanelle ultrasonography over a four-year period (between 1st May 2000 and 31st April 2004) were retrospectively analysed. The transfontanelle ultrasonographies were done using a two dimensional Sonoace 1500 (Medison Inc, South Korea 1995) ultrasound scanner fitted with 6.5 megahertz (MHz) curvilinear small head probe. The scans were done in both coronal and sagittal sections applying the standard techniques. RESULT: Atotal of 114 infants were seen in the study period with male to female ratio of 1:1. Sixty eight patients (59.65%) presented within the first 2 months of age. Hydrocephalus 34 (29.04%), seizure disorders 16 (14.04%) and suspected intracranial bleeding 19 (16.67%) constituted over half of the presenting complaints. The result showed that 54 patients (47.37%) had normal findings, 43 (37.72%) had hydrocephalus of which in 25 (21.93%) it was communicating while in 18 (15.79%) it was non-communicating 6 (5.26%) had cephalohaematoma, 5 (4.39%) had encephalcoele, 4 (3.51%) had periventricular leukomalacia, and 2 (1.75%) had subgaleal cyst. CONCLUSION: Transfontanelle ultrasonography is a useful technique for diagnosis of lesions within the infant brain. Hydrocephalus is the most frequent reason for request of transfontanelle ultrasound scan and also the most frequent abnormal finding. (+info)
Brain herniation in a neonate.
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Brain herniation is generally thought to be unlikely to occur in newborns due to the presence of the patent fontanelles and cranial sutures. A review of the literature published from 1993 to 2008 via MEDLINE search revealed no reports on neonatal brain herniation from intracranial tumour. We report a preterm Malay male infant born via elective Caesarean section for antenatally diagnosed intracerebral tumour, which subsequently developed herniation. Cerebral magnetic resonance imaging showed features that were compatible with a large complex intracranial tumour causing mass effect and gross hydrocephalus. Tumour excision was scheduled when the infant was two weeks old. Unfortunately, on the morning of the surgery, he developed signs of brain herniation and had profuse tumour haemorrhage during the attempted excision. Histopathological examination revealed an embryonal tumour, possibly an atypical rhabdoid/teratoid tumour. This case illustrates that intracranial tumours in newborns can herniate and should therefore be closely monitored. (+info)
Surface area measurement using rendered three-dimensional ultrasound imaging: an in-vitro phantom study.
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Anterior fontanelle size in healthy Iranian neonates on the first day of life.
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There is limited data in the literature on the normal size of the anterior fontanelle. This cross- sectional study was to determine normal values of anterior fontanelle size on the first day of life, using standard methods. Anterior fontanelle size was measured in 400 term and healthy neonates delivered at the Shariati Hospital, Tehran, Iran. Examination included assessment of head circumference, anterior fontanelle size, weight, length. Type of delivery was also recorded. The mean size of anterior fontanelle was 25.34 +/- 13.27 mm, and it was established in both genders, 26.70 +/- 13.19 mm in boys, and 23.67 +/- 13.20mm in girls. A significant difference between the mean anterior fontanelle size in boys and girls was found (P=0.023). There was no significant difference in anterior fontanelle size between the infants born with a normal vaginal delivery and those with cesarean-section (P=0.08). There was found a significant negative correlation between the mean size of anterior fontanelle size with both weight and height (P<0.05). No significant correlation was found between mean size of anterior fontanelle and head circumference or with gestational age of infant (P>/=0.05). Our results proved possible to define a references range and centile chart. The method used is simple and accurate and easy used in the routine neonatal examination. (+info)
Preterm screening by transfontanelar ultrasound - results of a 5 years cohort study.
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OBJECTIVES: Intracranial hemorrhages (ICH) might be the cause of significant psycho-motor or cognitive impairment in preterm babies. A 5 year cohort study performed in the IOMC was aimed at determining the prevalence and proportion of the main types of ICH diagnosed by transfontanelar (TF) ultrasound among admitted preterms, along with the neuro-developmental effects on a 12 month follow-up period. MATERIAL AND METHODS: In the above mentioned period all enrolled newborns were examined by TF ultrasound according to a common standardized protocol. The 4 grade Papile ICH classification was used for all examined subjects. In order to determine the potential neurological sequels we performed a 12 month neurological follow-up of all 292 patients in the study group. RESULTS: The prevalence of all types ICH diagnosed by systematic TF ultrasound was 20.4 %. The most prevalent type of ICH was peri-intraventricular: 40% grade I and 33 % grade II, with no major neurological sequels For both the correlation to the neurological outcome was statistically significant (p < 0.05). Severe neurological sequels were associated with grade III and IV, but the correlation was found to be statistically significant (p < 0.05) only for grade IV hemorrhages. A severe neurological outcome was of statistical significance only for the cerebellar hemorrhage outcome, although a similar pattern was also observed for the thalamic hemorrhages. CONCLUSION: Systematic TF screenings for preterm is useful for early diagnosis and staging which might improve the management of rehabilitation therapies, and provide appropriate information on the disease outcome as well as influencing the quality of parental counseling. (+info)