الفهرس 
Gross Anatomy of the BrainOnly 14 pages are availabe for public view
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Abstract
Hypoxic ischemic encephalopathy (HIE) is defined as acute non-static encephalopathy induced by intrapartum or late antepartum brain hypoxia and ischemia because of neonatal asphyxia.
Regardless the cause of asphyxia, the ultimate fetal cardiac and vascular compromise leads to reduced cerebral blood flow and loss of cerebral auto-regulation. These events lead to a cascade of deleterious events that lead eventually to neuronal cell death.
Hypoxic-ischemic encephalopathy (HIE) is considered one of the major causes of cerebral palsy in children such as mental retardation and epilepsy. The severity of the disease depends upon the degree of brain maturation, location and duration of injury.
Early diagnosis of risky infants of developing moderate to severe encephalopathy is essential to determine the effective supportive treatment methods.
Imaging is vital in the evaluation of brain insult in patients with neonatal encephalopathy by determining the timing, severity and the nature of injury and the expected neurological outcomes.
Transcranial ultrasonography is the only bedside tool able to image the neonatal brain, which is vital in critically ill infants. It can be done without sedation, easily repeatable and no ionizing radiation. It is also suitable for screening and follow-up examinations.
Color doppler sonography has widened applications in pediatric neuro-sonography for evaluation of cerebral vascular anatomy and perfusion. It can measure perfusion velocity so that tissue perfusion is quantified during a complete cardiac cycle.
Aim of the work
Is to demonstrate the role of transcranial grayscale and color Doppler ultrasound as a bed-side safe neuroimaging technique in diagnosis of neonatal hypoxic ischemic encephalopathy.
Subjects and methods
This study was performed on 20 neonates, collected during transcranial ultrasound examination. The study group consisted of 10 males and 10 females, age ranges from one day to 28 days from May 2019 to June 2020.
Patients were selected from Menof General Hospital, Shebin Elkom Teaching Hospital and other private hospitals picked up from the neonatology wards.
Patient selection was based on certain inclusion criteria involve neonates with clinically suspected or diagnosed as neonatal hypoxic-ischemic encephalopathy.
There were no significant exclusion criteria, however, some neonates whom were unfit for the examination especially with low oxygen saturation less than 90% due to lack of oxygen source in hands during transportation to radiological department were excluded from the study.
Detailed history and clinical examination and laboratory data including Complete blood count, Prothrombin time, Partial thromboplastin time were obtained from neonatal wards.
All patients were subjected to detailed ultrasound examination gray scale and color doppler assessment
For a standard CUS procedure, the anterior, posterior, temporal and mastoid fontanelles are used as acoustic windows.
Color coded Doppler study of the intracerebral vessels was particularly of value in assessing brain perfusion in our study to detect ischemic brain changes.