Abstract

Background

Transcranial ultrasonography, in experienced hands, is an outstanding tool to detect brain abnormalities in preterm and full-term infants, and to follow the progression of these lesions. Doppler sonography is an excellent modality for assessment of the cerebral vasculature in the newborn and provides valuable information about cerebral vascular anatomy.

Aim and Objectives

to discuss the value added by transcranial Doppler assessment of blood flow in major intracranial cerebral arteries to brain status evaluation in neonatal intracranial hemorrhagic and ischemic conditions by employing Doppler techniques.

Subjects and Methods

This was a prospective cohort study that was carried out at tertiary care centers.45 neonates admitted to the neonatal intensive care unit were enrolled based on having the clinical diagnosis of perinatal asphyxia and having ischemic and hemorrhagic cerebral changes on grey scale sonographic evaluation. Doppler interrogation of both anterior cerebral artery (ACA) and middle cerebral artery (MCA) was performed bilaterally. Follow up evaluation was performed upon discharge. It was conducted from October 2022 to April 2023.

Results

There was a statistically significant difference between the studied groups as regard (APGAR Score at 1 min and 5 min), (peak systolic velocity (PSV) (cm/s) of ACA and resistive index (RI)), (peak systolic velocity (PSV) (cm/s) of MCA and resistive index (RI)), Correlation between Severity of hemorrhagic and ischemic cerebral changes with other studied Parameters except in gestational age and body weight.

Conclusion

Ultrasonographic features and cerebral blood flow parameters are useful for the early diagnosis of hypoxic-ischemic encephalopathy and help predict outcome. In the presence of more extensive hypoxic-ischemic brain injury and statistically significantly lower peak systolic velocity and higher resistive index in the anterior and medial cerebral arteries, the outcomes were poorer.

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