Hypoxic/ischaemic cerebral injury in the neonatal brain

Ultrasound has been used in 11 neonates whose history or clinical features suggested the possibility of hypoxic/ischaemic lesions. The ultrasound findings were correlated with computed tomographic findings in nine infants and with pathological findings in two. On ultrasound scan, areas of increased echoes represented both hypoxic/ischaemic and haemorrhagic lesions. However, the distinction between them could not be made with certainty. Cystic changes were shown clearly by ultrasound as were cerebral vascular pulsations in and adjacent to the areas of increased echoes. With computed tomography, hypoxic/ischaemic lesions were represented by areas of decreased density and haemorrhagic lesions by areas of increased density. Computed tomography failed to clearly demonstrate the cystic changes. Three types of lesions, viz. diffuse, focal and periventricular were based on the location of brain injury, the former two occurring in term infants and the latter in premature infants. Ultrasound has been shown to be of value for definition of the site and extent of hypoxic/ischaemic cerebral lesions in the newborn and for observation of their evolution.