BRAIN MRI FINDINGS: IN NEONATES AT RISK OF ACUTE BILIRUBIN ENCEPHALOPATHY IN RELATION TO GESTATIONAL AGE, WEIGHT AND BILIRUBIN LEVEL AND NEURODEVELOPMENTAL OUTCOME

Manali Tiwari; Ram Sunder Sharma

Volume : VI, Issue : X, October - 2016

BRAIN MRI FINDINGS: IN NEONATES AT RISK OF ACUTE BILIRUBIN ENCEPHALOPATHY IN RELATION TO GESTATIONAL AGE, WEIGHT AND BILIRUBIN LEVEL AND NEURODEVELOPMENTAL OUTCOME

Manali Tiwari, Ram Sunder Sharma

Abstract :

AIMS: To describe ain MRI findings in neonates at risk of acute bilirubin encephalopathy in relation to gestational age, weight and bilirubin levels, age at imaging and neurodevelopmental outcome. MATERIAL AND METHODS: Neonates with TSB >18 mg/dl. Review of neonatal data, at birth and later, MRI scans and BERA and neurodevelopmental outcome. RESULTS: 22 neonates were studied, 2 < 31, 7 b/w 34–36 and 13 b/w 37–40 weeks GA. MRI showed abnormal SI in the BG in 14/22 at birth and 13/22 in later scans. Abnormal WM SI occurred in 12/22 at birth & 7/22 later scans. 13 infants developed motor/auditory sequelae. Adverse outcome was associated with high SI in BG (7/13) on late T2– weighted MRI (all GA) and abnormal BERA on follow up. WM and STN abnormalities, did not correlate with outcome. CONCLUSIONS: Severe sequelae occurred with relatively low TSB levels in preterm but at high levels in terms. In asymptomatic patients at presentation, follow up MRI and BERA can reliably predict abnormal neurodevelopment outcome.