LATERAL VENTRICULAR EFFACEMENT AS AN ISOLATED SONOGRAPHIC FINDING IN PREMATURE-INFANTS - PREVALENCE AND SIGNIFICANCE

OBJECTIVE. The sonographic finding of effaced lateral ventricles in pr emature infants, defined as the absence of visible CSF within the late ral Ventricles on both coronal and sagittal sonograms, may be cause to suspect diffuse cerebral edema, especially as published reference sta ndards do not address this phenomenon, This investigation was undertak en to determine the prevalence and significance of effaced lateral ven tricles without associated parenchymal abnormality (isolated lateral v entricular effacement, or ILVE) in premature infants. MATERIALS AND ME THODS. Sonographic records of 398 consecutive newborns examined from J anuary 1 to December 31, 1993, were reviewed retrospectively to identi fy those premature infants (<36 weeks of gestational age) whose initia l sonograms showed no evidence of intracranial hemorrhage, ventriculom egaly, structural abnormality, or abnormal parenchymal echogenicity. W e identified 142 neonates who met these criteria. Patients were separa ted into two groups on the basis of whether they had at least one sono graphic study in which CSF was not visible within both lateral ventric les on coronal and sagittal images. Medical records were reviewed to a ssess neurologic outcome, RESULTS. Forty patients (28%) had at least o ne sonogram demonstrating ILVE, with neurologic follow-up in 33 (repre senting group A). One hundred two patients (72%) never demonstrated IL VE, with neurologic follow-up established in 86 (representing group B) . A comparison of the two groups showed no significant difference in t he development of ischemic injury (one patient in each group). ILVE wa s first detected on the initial sonogram obtained (mean, 4 days) in 30 of the 33 neonates in group A. ILVE was demonstrated beyond the seven th day of life in 30%. Of the 89 patients whose initial sonograms show ed CSF in the lateral ventricles (86 in group B and three in group A), three (3%) subsequently had sonograms that showed ILVE; all three wer e normal at follow-up. CONCLUSION. ILVE in premature infants is common and not associated with neurologic deficits indicative of hypoxic-isc hemic encephalopathy. By itself, ILVE is not a significant finding.