Hypoxic-ischemic encephalopathy in term infants: diagnosis and prognosis evaluated by ultrasound.

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Abstract
The results of cranial ultrasonography in 32 term infants who had hypoxic-ischemic encephalopathy (HIE) and in 26 control infants were reviewed. Small or nonvisualized ventricles were present in 94% of the patients with HIE and in 62% of the control subjects. In 20 of the 32 patients (63%) with HIE, ultrasound demonstrated parenchymal abnormalities; the most common finding was periventricular hyperechogenicity (12/32 patients). There was a single false positive result in the control group. Of patients with HIE who had abnormalities demonstrated on ultrasonograms, 50% died (within 15 days of birth), whereas none of the infants who had normal ultrasound findings died. Moreover, 80% of surviving patients who had abnormal ultrasound findings had residual neurological deficits vs. only 11% of those with normal ultrasound findings. Ultrasound apparently is effective in detecting parenchymal changes in patients with HIE, parenchymal echoes are a more reliable sign of HIE than ventricular size, and the finding of parenchymal lesions on ultrasound scans appears to be predictive of abnormal motor development.

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