Ultrasound-clinical correlations in the assessment of the newborn at risk for brain damage.

In the Pavia Neonatal Intensive Care Unit all newborns at risk for brain damage have, since 1983, undergone transfontanellar ultrasound scanning regularly for the early diagnosis of hemorrhage and/or anoxia-ischemia. They have also been assessed clinically by a child neuropsychiatrist during the hospital stay and every two months at outpatients' for the first year of life as a check on the prognostic value of ultrasound scanning. The results relating to a sample of 56 at risk newborns, with normal and abnormal ultrasound scans, who have now reached 12 months corrected age are reported. A normal ultrasound scan presupposes normal neuropsychic development in 87% of cases, as happens in the event of uncomplicated hemorrhage. Major sequelae occur in as many as 83% of cases of complicated hemorrhage. The diagnosis of severe anoxia-ischemia likewise argues for a pathological neuropsychic development. Our results convince us that transfontanellar ultrasound scanning is an indispensable tool not only for the early diagnosis of brain damage but also as a guide to prognosis in the newborn at risk.