Role of Neuroimaging Techniques in Neonatal Surgery

The aim of the study was to establish the frequency and nature of cerebral lesions using methods of neuroimaging, which determine transient and irreversible lesions of the CNS function in newborn children with malformations of internal organs in the perioperative period.

Methods of Research: To achieve this goal, 411 medical histories of children with congenital defects of internal organs were analyzed. All children were examined during 10 month. About 80% of the children needed surgical correction of congenital malformations, 36% of them were operated in the first 4-8 hours from the moment of birth, 22% - by the end of 1 day of life. The remaining children were operated in the period from 2 to 18 days of life and later. An MRI scan was performed in 6.2% of 411 newborns with congenital malformations of internal organs. Including 2 children suffered congenital diaphragmatic hernia, 9 children - gastroschisis, hydronephrosis, 6 children with duodenal stenosis, multiple congenital malformations, 8 newborns - lung adenomatosis, bronchogenic cyst, omphalocele.

Results: Based on the results of a comprehensive neurological and clinical-instrumental examination of children with congenital defects of the internal organs, more than 42% had signs of CNS damage. According to MRI, intraventricular hemorrhages were detected in 3.3% of 411 patients with malformations of internal organs, sub-oral (subdural and subarachnoid) hemorrhages - in 1.2%, cerebral cysts - in 0.4%, parenchymal hemorrhages - in 0.8%. Expansion of external and internal cerebrospinal spaces in combination with intraventricular hemorrhage of varying severity, expansion of subdural space was observed more often in the group of children with congenital diaphragmatic hernia and spinal hernia in 20%.

Conclusions: For a full assessment of risk factors, children with congenital malformations need outpatient monitoring with assessment of psychomotor development. Neurosonography and MRI are complementary methods diagnosis of congenital and perinatal lesions brain.