301. Superficial Echogenic Lesions Detected on Neonatal Cranial Sonography: Possible Indicators of Severe Birth Injury
- Author
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Sung Bin Park, Sun Young Ko, Kyung Sang Lee, Seung Koo Lee, Byoung Hee Han, Mi Jin Song, Young-Hwa Kim, and Goun Jung
- Subjects
Hematoma, Epidural, Cranial ,Male ,medicine.medical_specialty ,Birth trauma ,Sensitivity and Specificity ,Hypoxic Ischemic Encephalopathy ,030218 nuclear medicine & medical imaging ,Diagnosis, Differential ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,Epidural hematoma ,Birth Injuries ,medicine ,Humans ,Radiology, Nuclear Medicine and imaging ,Periventricular leukomalacia ,Radiological and Ultrasound Technology ,medicine.diagnostic_test ,business.industry ,Infant, Newborn ,Reproducibility of Results ,Magnetic resonance imaging ,Cranial Sutures ,medicine.disease ,Echoencephalography ,Magnetic Resonance Imaging ,Intracranial Hemorrhage, Traumatic ,Surgery ,Intraventricular hemorrhage ,Hypoxia-Ischemia, Brain ,Germinal matrix hemorrhage ,Female ,Radiology ,business ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
Objectives The purpose of this study was to evaluate the characteristics and importance of superficial echogenic lesions around cranial sutures on neonatal cranial sonography. Methods We retrospectively reviewed the clinical records and neuroimaging studies of 40 neonates who had superficial echogenic lesions around sutures on neonatal cranial sonography. Magnetic resonance imaging (n = 18) and computed tomography (n = 2) were performed within 2 weeks after sonography. We correlated sonographic findings with computed tomographic and magnetic resonance imaging findings and analyzed them. We also evaluated the associated lesions, neurologic signs, and follow-up changes. Results Sonographically, the superficial echogenic lesions involved both sulci and perisulcal parenchyma in 39 neonates and were located in the frontal and parietal areas around the sagittal suture in 38 neonates. Magnetic resonance imaging revealed a pattern of hypoxic ischemic encephalopathy in 9 neonates, birth trauma in 3 neonates, a mixed pattern of hypoxic ischemic encephalopathy and trauma in 3 neonates, nonspecific single infarctions in 2 neonates, and lack of a defined lesion in 1 neonate. The associated lesions were subdural hemorrhage (n = 12), epidural hematoma (n = 4), germinal matrix hemorrhage (n = 3), intraventricular hemorrhage (n = 2), and periventricular leukomalacia (n = 1). All epidural hematomas were associated with scalp hematoma, and 2 patients had skull fractures. One neonate with epidural hematoma associated with a hypoxic ischemic encephalopathy pattern showed mild spasticity in both ankles until 16 months. Conclusions Superficial echogenic lesions detected around cranial sutures on neonatal sonography may be an indicator of more serious intracranial lesions such as more extensive hypoxic ischemic encephalopathy and intracranial hematomas, including epidural hematoma.
- Published
- 2015