Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates
Intraventricular hemorrhage (IVH) is a common complication encountered in extremely-low-birth-weight (ELBW) and very-low-birth-weight (VLBW) premature babies. The neurologic outcome of these patients is influenced by the magnitude of the hemorrhagic process that damages the involved anatomic structu...
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2025-06-01
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| author | Adriana Mihaela Dan Diana Iulia Vasilescu Ion Dragomir Sorin Liviu Vasilescu Diana Voicu Monica Mihaela Cîrstoiu |
| author_facet | Adriana Mihaela Dan Diana Iulia Vasilescu Ion Dragomir Sorin Liviu Vasilescu Diana Voicu Monica Mihaela Cîrstoiu |
| author_sort | Adriana Mihaela Dan |
| collection | DOAJ |
| description | Intraventricular hemorrhage (IVH) is a common complication encountered in extremely-low-birth-weight (ELBW) and very-low-birth-weight (VLBW) premature babies. The neurologic outcome of these patients is influenced by the magnitude of the hemorrhagic process that damages the involved anatomic structures but also by the impaired circulation of cerebrospinal fluid (CSF) through the ventricular system, leading to posthemorrhagic ventriculomegaly (PHVM). Cranial ultrasound (CUS) performed by neonatologists (point-of-care ultrasound—POCUS) facilitates the early diagnosis of IVH and PHVM and can objectively quantify structural alterations. Our aim was to identify the best sonographic criteria to follow-up with ventricular dilatation and predict the need for neurosurgery and neurologic deterioration. We performed a literature review in search of the most relevant ventricular measurements considered by neurosurgeons, neonatologists, and pediatric neurologists to reflect the risk of white matter injury and high intracranial pressure (HIP), thus anticipating neurologic developmental impairment (NDI). The tridimensional picture of ventricular dilatation is best captured if more than one index (ventricular index and anterior horn width) or ratio (Evans ratio, fronto-occipital horn ratio, and fronto-temporal horn ratio) is used. <b>Conclusions</b>: If performed using the correct protocol, serially and comprehensively, CUS is an indispensable tool for the diagnosis and follow-up of neurologic complications of preterm babies, and it can make a difference in guiding adequate intervention and improving long-term developmental outcomes. |
| format | Article |
| id | doaj-art-4f4c1624ce2a4ecc8680292f9ee76e14 |
| institution | Kabale University |
| issn | 2227-9067 |
| language | English |
| publishDate | 2025-06-01 |
| publisher | MDPI AG |
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| series | Children |
| spelling | doaj-art-4f4c1624ce2a4ecc8680292f9ee76e142025-08-20T03:27:14ZengMDPI AGChildren2227-90672025-06-0112676810.3390/children12060768Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature NeonatesAdriana Mihaela Dan0Diana Iulia Vasilescu1Ion Dragomir2Sorin Liviu Vasilescu3Diana Voicu4Monica Mihaela Cîrstoiu5Faculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 050474 Bucharest, RomaniaDepartment of Neonatology, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaDepartment of Obstetrics and Gynecology, Emergency University Hospital Bucharest, 050098 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 050474 Bucharest, RomaniaFaculty of Medicine, “Carol Davila” University of Medicine and Pharmacy Bucharest, 050474 Bucharest, RomaniaIntraventricular hemorrhage (IVH) is a common complication encountered in extremely-low-birth-weight (ELBW) and very-low-birth-weight (VLBW) premature babies. The neurologic outcome of these patients is influenced by the magnitude of the hemorrhagic process that damages the involved anatomic structures but also by the impaired circulation of cerebrospinal fluid (CSF) through the ventricular system, leading to posthemorrhagic ventriculomegaly (PHVM). Cranial ultrasound (CUS) performed by neonatologists (point-of-care ultrasound—POCUS) facilitates the early diagnosis of IVH and PHVM and can objectively quantify structural alterations. Our aim was to identify the best sonographic criteria to follow-up with ventricular dilatation and predict the need for neurosurgery and neurologic deterioration. We performed a literature review in search of the most relevant ventricular measurements considered by neurosurgeons, neonatologists, and pediatric neurologists to reflect the risk of white matter injury and high intracranial pressure (HIP), thus anticipating neurologic developmental impairment (NDI). The tridimensional picture of ventricular dilatation is best captured if more than one index (ventricular index and anterior horn width) or ratio (Evans ratio, fronto-occipital horn ratio, and fronto-temporal horn ratio) is used. <b>Conclusions</b>: If performed using the correct protocol, serially and comprehensively, CUS is an indispensable tool for the diagnosis and follow-up of neurologic complications of preterm babies, and it can make a difference in guiding adequate intervention and improving long-term developmental outcomes.https://www.mdpi.com/2227-9067/12/6/768intraventricular hemorrhagerisk factorsneurologic outcomecranial ultrasoundposthemorrhagic ventriculomegaly |
| spellingShingle | Adriana Mihaela Dan Diana Iulia Vasilescu Ion Dragomir Sorin Liviu Vasilescu Diana Voicu Monica Mihaela Cîrstoiu Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates Children intraventricular hemorrhage risk factors neurologic outcome cranial ultrasound posthemorrhagic ventriculomegaly |
| title | Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates |
| title_full | Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates |
| title_fullStr | Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates |
| title_full_unstemmed | Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates |
| title_short | Cranial Ultrasonography—Standards in Diagnosis of Intraventricular Hemorrhage and Ventricular Dilatation in Premature Neonates |
| title_sort | cranial ultrasonography standards in diagnosis of intraventricular hemorrhage and ventricular dilatation in premature neonates |
| topic | intraventricular hemorrhage risk factors neurologic outcome cranial ultrasound posthemorrhagic ventriculomegaly |
| url | https://www.mdpi.com/2227-9067/12/6/768 |
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