ABSTRACT
Cranial sonography has become the main modality of the investigation and diagnosis
of a wide variety of neonatal intracranial abnormalities. Occasionally, cranial sonograms
reveal basal ganglia and thalami bright echoes. It is believed that these lesions
are indicative of vasculitis due to intrauterine infections, in particular with cyto-megalovirus
(CMV). We hypothesized that the incidence of proven neonatal intrauterine TORCH infection
is low and that screening of all asymptomatic infants with bright lenticulostriate
echodensities would not be cost-effective. We reviewed brain sonograms of 3700 infants,
performed over a period of 3 1/2 years. Echogenic basal ganglia vasculature were observed
in 75 patients (2%). Chart review performed for clinical presentation and TORCH studies
showed that only one infant had confirmed intrauterine congenital infection, which
was by CMV. This infant had no signs or symptoms of CMV. In addition, there were 4
patients with chromosomal anomalies among the 75 patients (5%), of these one had trisomy
13 and another-trisomy 21. Our results indicate that echogenic basal ganglia blood
vessels are not an exceptional finding on cranial sonograms, and are seldom associated
with intrauterine infection. We conclude that it is not cost-effective to screen infants
with echogenic basal ganglia blood vessels for intrauterine infection, unless clinical
suspicion exists.
Keywords
Head sonogram - basal ganglia - thalamus - intrauterine infection - echogenic blood
vessels
