Value of cranial ultrasound at initiation of therapeutic hypothermia for neonatal encephalopathy

There is variation in the clinical practice for the use of cranial ultrasound (cUS) at the time of initiation of therapeutic hypothermia (TH) for neonatal encephalopathy. The role of cUS in selecting patients who may benefit from TH or excluding those where TH may impose risk is unknown.A retrospective study was conducted on infants who received TH at a single tertiary center. Findings from cUS at initiation of TH were compared to findings from MRI following the completion of TH.One hundred and eight infants were studied. Of the 55 with abnormalities on early cUS, 50 did not have corresponding MRI abnormalities. In contrast, 16 infants had some degree of intracranial hemorrhage detected on their MRI that was not noted on earlier cUS.This study challenges whether cUS is an essential universal screening tool prior to the commencement of TH.