Computerised tomography (CT) and electroencephalography (EEG) in the immediate evaluation of term infants with symptomatic birth asphyxia

Twelve full term asphyxiated neonates who exhibited evidences of hypoxic-ischemic encephalopathy (HIE) were subjected to computerised tomography (CT) and electroencephalography (EEG), in order to evaluate the immediate prognostic values of these two, noninvasive techniques. CT scan was also done in one normal term newborn and EEG in ten normal term neonates to serve as controls. CT findings revealed normal scans in two, borderline normal scans in two, tentorial hemorrhages with hydrocephalus but without parenchymal bleeds in two, gross cerebral edema in four, cerebral atrophy and hydrocephalus in one each. Repeat scans done in both infants with tentorial hemorrhages, at 2 months, revealed complete resolution of bleeds and decrease in ventricular size. EEG were within normal limits in four and abnormal in the rest. Four infants died, three of asphyxia and one of pyogenic meningitis. The three who died of asphyxia had clinical evidences of a severe encephalopathy along with significant abnormalities on scan (gross cerebral edema) and on EEG (very low amplitude). Of the eight surviving infants, six are neurologically normal so far, while two have evidences of spastic cerebral palsy. Both neonates with tentorial bleeds are normal at 6 months, although both had a moderately severe neonatal neurological syndrome.