Sequential CT scanning after neonatal intracerebral hemorrhage

Sequential computed tomographic scans were obtained in 41 neonates surviving intracerebral hemorrhage and in 41 comparable neonates without hemorrhage. Hemorrhages were present in only the parenchyma in five patients in both parenchyma and ventricles in 22, and in only the ventricles in 14. No patient exhibited progression of the initial hemorrhage on subsequent scans. Parenchymal hemorrhages were followed by areas of parenchymal hypodensity in 30%. The size of the mitral parenchymal hemorrhage did not correlate with the size of the subsequent hypodense areas. Intraventricular hemorrhages were small in 36%, moderate in 28%, and extensive in 36%. Clinically significant hydrocephalus developed in 32% of the patients and did not correlate with the extent of the intraventricular hemorrhage. Periventricular hypodensity was present at some time in 95% of neonates who bled and was present in 85% of the scans at 30-60 days of age. In the neonates without intracerebral hemorrhages, periventricular hypodensity was present in 57.5%. The hypodensity is thought due to leukomalacia, which may predict subsequent neurologic sequelae better than the severity of the hemorrhage or the development of hydrocephalus.
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