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Context: Intraventricular hemorrhage and periventricular leukomalacia, the common brain injuries in premature infants, are major causes for early death in the neonatal period and later motor and cognitive disabilities. This study was undertaken to find out the incidence of normal cranial ultrasound (CUS), normal variants, and abnormal CUS findings. Evidence Acquisition: This prospective, observational study was conducted at Neonatal ICU, Department of Paediatrics, Civil Hospital, Ahmedabad, over a period of 2 years from September 1, 2014, to August 31, 2016. Detailed history, examination, and risk factor assessment was done for all 180 subjects. The neonates were subjected to cranial ultrasound during admission and on follow-up. Results: Upon sonographic evaluation, 125 (69.44%) neonates had normal ultrasound, 34 (18.90%) had normal variants, and 21 (11.66%) had abnormal cranial ultrasound findings. The predominant normal variants observed were cavum septum pellucidum (18; 10%) and choroid plexus cyst (11; 6.1%). The most common abnormality detected was intraventricular hemorrhage (15; 8.3%) and was found to have a clinically significant correlation with surfactant use and with mechanical ventilation ( P value < .05). Follow-up scans could be performed on 70 subjects out of which 2 had normal variants and 3 had abnormal CUS findings. Conclusion: Establishing institutional CUS scanning protocols will go a long way in decreasing morbidity and mortality in preterm neonates.

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