Patologia cerebrale diagnostica con l'ultrasonografia in neonati di peso ≤ 1500 G. E/O eta gestazionale ≤ 32 settimane

We refer data of 102 infants weighing ≤ 1500 g. and/or born before 32 weeks gestation that were in our Hospital and were followed up with neurological examination and with cranial sonography for about two years. We found: 54 cases with no sonographic abnormalities, 18 cases with intracranial hemorrhage, 38 cases with periventricular hyperecogenicity and 6 cases with other pathologies (3 non hemorrhagic ventricular enlargements, i case with diffuse calcifications and 2 cases with vasculitis striae). As the cerebral pathology is developping, we have found 3 diagnostic sonographic moments: 1) ECOD: diagnosis during time spent in hospital; 2) ECO40: diagnosis performed at term-corrected age; 3) ECOF: diagnosis at the end of follow-up. ECOD showed 54 normal cases and 48 pathological cases. ECO40 (86 cases) showed 65 normal cases and 21 pathological cases. All the normal cases at ECOD are as well normal at ECO40 while 19 pathological cases at ECOD are now (ECO40) normal (less serious intraventricular hemorrhage and hyperecogenicity). ECOF confirmed all the pathological diagnosis, while 14 normal cases became pathological during the follow-up: they are the brain injury outcomes that are evinced only later (ventricular enlargement, increased subarachnoid spaces, cerebral atrophy). The three diagnostic sonographic moments are significantly correlated to the neurological outcomes; ECO40 is the more significative for the outcome. There were more hemorrages, more serious hemorrage and more exitus in infants weighing < 1000 g. Neurological handicap is correlated overall to leukomalacia with cystic evolution or with persistent hyperecogenicity. The periventricular hyperecogenicity is significantly correlated to infants born before 28 weeks gestation. We can conclude that the more serious hemorrhages influences the survival while the leukomalacia influences the neurological outcome.