RESUMEN
BACKGROUND: The SARS-CoV-2 virus has been a global public health threat since December 2019. This study aims to investigate the neurological characteristics and risk factors of coronavirus disease 2019 (COVID-19) in Taiwanese children, using data from a collaborative registry. METHODS: A retrospective, cross-sectional, multi-center study was done using an online network of pediatric neurological COVID-19 cohort collaborative registry. RESULTS: A total of 11160 COVID-19-associated emergency department (ED) visits and 1079 hospitalizations were analyzed. Seizures were the most common specific neurological symptom, while encephalitis and acute disseminated encephalomyelitis (ADEM) was the most prevalent severe involvement. In ED patients with neurological manifestations, severe neurological diagnosis was associated with visual hallucination, seizure with/without fever, behavior change, decreased GCS, myoclonic jerk, decreased activity/fatigue, and lethargy. In hospitalized patients with neurological manifestations, severe neurological diagnosis was associated with behavior change, visual hallucination, decreased GCS, seizure with/without fever, myoclonic jerk, fatigue, and hypoglycemia at admission. Encephalitis/ADEM was the only risk factor for poor neurological outcomes at discharge in hospitalized patients. CONCLUSION: Neurological complications are common in pediatric COVID-19. Visual hallucination, seizure, behavior change, myoclonic jerk, decreased GCS, and hypoglycemia at admission are the most important warning signs of severe neurological involvement such as encephalitis/ADEM.
Asunto(s)
COVID-19 , SARS-CoV-2 , Humanos , Taiwán/epidemiología , COVID-19/complicaciones , COVID-19/epidemiología , Estudios Transversales , Niño , Masculino , Femenino , Estudios Retrospectivos , Preescolar , Adolescente , Lactante , Factores de Riesgo , Enfermedades del Sistema Nervioso/etiología , Hospitalización/estadística & datos numéricos , Servicio de Urgencia en Hospital/estadística & datos numéricos , Convulsiones/etiología , Convulsiones/epidemiología , Sistema de RegistrosRESUMEN
PURPOSE: Adolescents with Tourette syndrome (TS) may suffer from learning difficulties (attention-deficit/hyperactivity disorder), challenges in interpersonal interactions (especially with peers), disruptions of daily routines (disruptive behavior disorders), and increased psychosocial stress, which can result in internalizing and externalizing behavioral problems, such as venting depression and stress through self-harm. The aim of this study was to investigate peer attachment in adolescents with TS and associated risk factors. DESIGN AND METHODS: Adolescents with TS aged 13-18 years were recruited from the outpatient departments of 2 hospitals in Taiwan. Participants completed a basic data sheet, the Beck Depression Inventory-II, the Chinese version of the State-Trait Anxiety Inventory, and the Chinese version of the Youth Self-Report. Descriptive statistics were performed. Structural equation modeling was used to verify the model proposed in this study and to analyze the overall fit and internal structure. RESULTS: A total of 452 adolescents with TS aged 10-19 years participated in this study, which aimed to investigate factors affecting peer attachment, depression, anxiety, and psychosocial maladaptation and to explore causal relationships between these factors. Peer attachment was significantly associated with grade point average (rs = -0.240, p < .001), birth order (rs = -0.118, p = .012), parental marital status (rs = -0.111, p = .018), parenting style (rs = -0.138, p = .003), family monthly income (rs = 0.124, p = .008), and weekly hours on the internet (r = -0.164, p < .001). CONCLUSIONS: These results suggest that depression, anxiety, and peer attachment affect psychosocial development. PRACTICAL IMPLICATIONS: The findings may help clinical staff manage adolescents' severe emotional distress and psychosocial maladaptation.
Asunto(s)
Trastorno por Déficit de Atención con Hiperactividad , Síndrome de Tourette , Humanos , Adolescente , Síndrome de Tourette/psicología , Taiwán , Estudios Transversales , Trastorno por Déficit de Atención con Hiperactividad/psicología , Relaciones InterpersonalesRESUMEN
The COVID-19 pandemic has evolved to immune escape and threatened small children and the elderly with a higher severity and fatality of non-pulmonary diseases. These life-threatening non-pulmonary COVID-19 diseases such as acute necrotizing encephalopathies (ANE) and multisystem inflammatory syndrome in children (MIS-C) are more prevalent in children. However, the mortality of multisystem inflammatory syndrome in adults (MIS-A) is much higher than that of MIS-C although the incidence of MIS-A is lower. Clarification of immunopathogenesis and genetic susceptibility of inflammatory non-pulmonary COVID-19 diseases would provide an appropriate guide for the crisis management and prevention of morbidity and fatality in the ongoing pandemic. This review article described three inflammatory non-pulmonary COVID-19 diseases including (1) meningoencephalitis (ME), (2) acute necrotizing encephalopathies (ANE), and (3) post-infectious multisystem inflammatory syndrome in children (MIS-C) and in adults (MIS-A). To prevent these life-threatening non-pulmonary COVID-19 diseases, hosts carrying susceptible genetic variants should receive prophylactic vaccines, avoid febrile respiratory tract infection, and institute immunomodulators and mitochondrial cocktails as early as possible.
Asunto(s)
Encefalopatías , COVID-19 , Adulto , Niño , Anciano , Humanos , PandemiasRESUMEN
AIMS: To explore the effects of preferred music therapy on peer attachment, depression, and salivary cortisol among early adolescents. BACKGROUND: As adolescents enter puberty, they start to seek partnering relationships among peers. Peer attachment is central for adolescents and greatly influences their physical and psychological development. DESIGN: A pre-test-posttest control group design. METHODS: The data were collected from July - October 2016. A total of 65 individuals were included. The treatment group received 40 min of music therapy twice per week over the course of 10 weeks. The control group maintained its typical routine. The research data were collected using structured questionnaires, including basic information, the Inventory of Peer Attachment, the Beck Depression Inventory-II questionnaires, and salivary cortisol concentrations. Statistical analysis methods included percentages, chi-square tests, t tests, analyses of covariance, and the Johnson-Neyman technique. RESULTS: There were statistically significant differences in peer attachment, depression, and salivary cortisol levels in the music group compared to the control group (p < 0.05). Additionally, the findings showed that early adolescents with more severe depression experienced greater improvement through preferred music therapy. CONCLUSION: The results allude to the beneficial effects of receiving preferred music therapy in terms of the peer attachment, depression, and salivary cortisol levels of early adolescents. Adjustments should be made based on the characteristics of student groups to develop suitable and safe music therapy and to reduce the risks of poor mental health.
Asunto(s)
Conducta del Adolescente/psicología , Pueblo Asiatico/psicología , Trastorno Depresivo/terapia , Hidrocortisona/análisis , Musicoterapia/métodos , Saliva/química , Adolescente , Femenino , Humanos , Relaciones Interpersonales , Masculino , Grupo Paritario , TaiwánRESUMEN
Trapped temporal horn of lateral ventricle (TTHLV) is a rare condition of isolated focal hydrocephalus. We report two cases with different presentations, etiologies, and surgical managements. The first case involved an extremely preterm male baby with a history of ventriculitis and intraventricular hemorrhage; he received external ventricle drainage twice due to obstructive hydrocephalus. TTHLV was detected by sonography. He received a ventriculoperitoneal shunt involving two catheters to bypass the adhesion site. There was no ventricular dilatation during 2 years of follow-up. The second case involved a term baby with an enlarged head; brain sonography revealed left focal hydrocephalus with TTHLV and mild midline shift. Neuroendoscopic cystoventriculostomy with fenestration from the left trigone to the frontal horn was performed and serial follow-up brain sonography for 3 months showed decreased ventricle size. The suitable surgical techniques for the management of TTHLV should be adjusted according to the patients' condition to obtain more favorable outcomes. Brain sonography can be a useful tool for the diagnosis and for following up the surgical outcomes in infants with TTHLV.
RESUMEN
OBJECTIVES: The aim of this study was to establish reference ranges for the corpus callosum in infancy and to clarify how sexual dimorphism evolves between the fetal stage and infancy. METHODS: Normal sonograms from cerebral ultrasonographic examinations of 1- to 6-month-old healthy full-term infants were selected. The length and thickness of the corpus callosum were determined, and the effect of sex on these values was analyzed. Studies on corpus callosum sexual dimorphism were reviewed. RESULTS: In total, sonograms from 236 1- to 6-month-old infants (120 male and 116 female) were collected, and the typical values (5th-95th percentiles) of the corpus callosum were determined for each group. During the first 2 months, with and without brain size adjustment, the corpus callosum in female infants was significantly thicker than that in male infants (mean thickness ± SD: 1 month, male infant, 1.8 ± 0.3 mm; female infant, 2.1 ± 0.3 mm; P = .005; 2 months, male infant, 1.8 ± 0.2 mm; female infant, 2.0 ± 0.3 mm; P = .002). The corpus callosum thickness of male and female infants had no significant differences after 2 months of age. Sexual dimorphism was not detected in corpus callosum length. CONCLUSIONS: Our study provides reference data on typical corpus callosum development in infants. In the fetal period and early infancy, the corpus callosum in female infants is thicker than that in male infants. From 3 months onward, the corpus callosum sexual dimorphism becomes insignificant throughout childhood. The evolvement of corpus callosum sexual dimorphism suggests that maternal factors may influence brain development.
Asunto(s)
Desarrollo Infantil/fisiología , Cuerpo Calloso/anatomía & histología , Ultrasonografía/métodos , Cuerpo Calloso/fisiología , Femenino , Humanos , Lactante , Masculino , Valores de Referencia , Factores SexualesRESUMEN
Posterior fossa hemorrhage is rare in term baby and difficult to assess. The clinical signs are nonspecific and usually delay the diagnosis. We present a 5-day-old male neonate of posterior fossa hemorrhage with the initial presentations of fever and seizure and early deduced by cranial ultrasonography findings as hyperechoic, asymmetric, ill-defined density and complicated with hydrocephalus. Magnetic resonance imaging of the head verified the diagnosis. Hemophilia A was confirmed thereafter by serology.
RESUMEN
Neonatal brain tumor is rare and its outcome is generally poor. We reported a 17-day-old neonate presented as enlarged head girth. The pathological finding showed an embryonal tumor with multilayered rosettes.
RESUMEN
PURPOSE: Reversible splenial lesion syndrome is a distinct clinicoradiological syndrome with diverse etiologies. Hypoglycemia induced reversible splenial lesion syndrome has been documented in adults and children, but rare in neonates. We demonstrate a neonate with hypoglycemia presenting with a typical reversible splenial syndrome. CASE REPORT: Patient A four-day-old male neonate had hypoglycemia and seizure, whose symptoms improved soon after glucose supplementation. Magnetic resonance imaging examination showed restricted diffusion of the splenium of the corpus callosum. Proton MR spectroscopy revealed a decreased N-acetylaspartate peak. The lesion resolved in subsequent MRI images. The patient is free from clinical symptoms and has normal development currently. CONCLUSION: The patient presented typical clinical course and radiological features of reversible splenial lesion syndrome. Through timely and proper treatment, the outcome could be favorable.
Asunto(s)
Ácido Aspártico/análogos & derivados , Cuerpo Calloso/patología , Hipoglucemia/metabolismo , Enfermedades del Recién Nacido/metabolismo , Convulsiones/metabolismo , Ácido Aspártico/metabolismo , Cuerpo Calloso/metabolismo , Humanos , Recién Nacido , Imagen por Resonancia Magnética , Espectroscopía de Resonancia Magnética , MasculinoRESUMEN
The coronavirus disease 2019 (COVID-19) pandemic has evolved to dynamic waves of different SARS-CoV-2 variants. Initially, children diagnosed with COVID-19 presented pulmonary involvement characterized by mild diseases. In the later waves of the COVID-19 pandemic, life-threatening non-pulmonary inflammatory diseases such as (1) aseptic meningoencephalitis (ME), (2) acute necrotizing encephalopathies (ANE), and (3) multisystem inflammatory syndrome in children (MIS-C) have been reported, affecting the pediatric population. To alert timely identification and prevention of the life-threatening non-pulmonary COVID-19, we present the cases of ME, ANE, and MIS-C in terms of clinical manifestation, cytokine profile, and follow-up consequences. Based on the immunopathogenesis and risk factors associated with non-pulmonary COVID-19, we delineate strategies for an early diagnosis and treatment to reduce morbidity and mortality in children.
RESUMEN
We have shown in vivo and in vitro previously that psychosine causes dysfunction of autophagy and the ubiquitin-proteasome system underlying the pathogenesis of globoid cell leukodystrophy (GLD), a devastating lysosomal storage disease complicated by global demyelination. Here, we investigated the therapeutic efficacy of the mTOR inhibitor rapamycin in twitcher mice, a murine model of infantile GLD, in biochemical, histochemical, and clinical aspects. Administration of rapamycin to twitcher mice inhibited mTOR signaling in the brains, and significantly reduced the accumulation of insoluble ubiquitinated protein and the formation of ubiquitin aggregates. The astrocytes and microglia reactivity were attenuated in that reactive astrocytes, ameboid microglia, and globoid cells were reduced in the brains of rapamycin-treated twitcher mice. Furthermore, rapamycin improved the cortical myelination, neurite density, and rescued the network complexity in the cortex of twitcher mice. The therapeutic action of rapamycin on the pathology of the twitcher mice's brains prolonged the longevity of treated twitcher mice. Overall, these findings validate the therapeutic efficacy of rapamycin and highlight enhancing degradation of aggregates as a therapeutic strategy to modulate neuroinflammation, demyelination, and disease progression of GLD and other leukodystrophies associated with intracellular aggregates.
Asunto(s)
Enfermedades Desmielinizantes , Leucodistrofia de Células Globoides , Ratones , Animales , Leucodistrofia de Células Globoides/tratamiento farmacológico , Leucodistrofia de Células Globoides/patología , Galactosilceramidasa/metabolismo , Galactosilceramidasa/uso terapéutico , Agregado de Proteínas , Enfermedades Neuroinflamatorias , Sirolimus/farmacología , Sirolimus/uso terapéutico , Enfermedades Desmielinizantes/tratamiento farmacológico , Ubiquitinas , Serina-Treonina Quinasas TORRESUMEN
BACKGROUND: This study aimed to understand the longitudinal relationship between psychosocial stress with tic exacerbation in children with Tourette syndrome (TS) and chronic tic disorder. METHODS: Consecutive ratings of tic severity as well as child and parental reports of psychosocial stress were obtained for 373 children (296 males, 77 females; mean age 9y 5mo; SD 3y 3mo) with TS and chronic tic disorder between January 2018 and December 2020. The Yale Global Tic Severity Scale (YGTSS) global severity score, total tic score, and impairment rating were calculated. The stressful events and YGTSS measurements were used and treated as time-varying variables in the analyses. Models that controlled for non-independence among the repeated observations using a random intercept and random slope model were employed. Each participant was treated as a random factor in the modelling. RESULTS: Family-related stress, personal relationship stress and school-related stress were independently associated with increasing YGTSS global severity, total tic score, and impairment rating over time. An increased number of stressful events were associated with increased severity of tics. CONCLUSION: Family, personal relationships, and school-related stress were consistently associated with the exacerbation of tics. Managing these stressful events is important in the treatment of TS and chronic tic disorder.
RESUMEN
Primary intracranial ependymoma is a challenging tumor to treat despite the availability of multidisciplinary therapeutic modalities, including surgical resection, radiotherapy, and adjuvant chemotherapy. After the completion of initial treatment, when resistant tumor cells recur, salvage therapy needs to be carried out with a more precise strategy. Circulating tumor cells (CTCs) have specifically been detected and validated for patients with primary or recurrent diffused glioma. The CTC drug screening platform can be used to perform a mini-invasive liquid biopsy for potential drug selection. The validation of potential drugs in a patient-derived xenograft (PDX) mouse model based on the same patient can serve as a preclinical testing platform. Here, we present the application of a drug testing model in a six-year-old girl with primary ependymoma on the posterior fossa, type A (EPN-PFA). She suffered from tumor recurrence with intracranial and spinal seeding at 2 years after her first operation and extraneural metastases in the pleura, lung, mediastinum, and distant femoral bone at 4 years after initial treatment. The CTC screening platform results showed that everolimus and entrectinib could be used to decrease CTC viability. The therapeutic efficacy of these two therapeutic agents has also been validated in a PDX mouse model from the same patient, and the results showed that these two therapeutic agents significantly decreased tumor growth. After precise drug screening and the combination of focal radiation on the femoral bone with everolimus chemotherapy, the whole-body bone scan showed significant shrinkage of the metastatic tumor on the right femoral bone. This novel approach can combine liquid biopsy, CTC drug testing platforms, and PDX model validation to achieve precision medicine in rare and challenging tumors with extraneural metastases.
RESUMEN
SCALP syndrome is an acronym describing the coincidence of sebaceous nevus syndrome, central nervous system malformations, aplasia cutis congenita, limbal dermoid, and pigmented nevus (giant congenital melanocytic nevus). We present a fourth case of this syndrome.
Asunto(s)
Sistema Nervioso Central/anomalías , Displasia Ectodérmica/patología , Nevo Pigmentado/patología , Nevo Sebáceo de Jadassohn/patología , Neoplasias Cutáneas/patología , Sistema Nervioso Central/patología , Femenino , Humanos , Recién Nacido , Nevo Pigmentado/congénito , Nevo Sebáceo de Jadassohn/congénito , Neoplasias Cutáneas/congénito , SíndromeRESUMEN
The MELAS syndrome primarily affecting the CNS is mainly caused by the m.A3243G mutation. The heteroplasmy in different tissues affects the phenotypic spectrum, yet the impact of various levels of m.A3243G heteroplasmy on CNS remains elusive due to the lack of a proper neuronal model harboring m.A3243G mutation. We generated induced neurons (iNs) through the direct reprogramming of MELAS patients, with derived fibroblasts harboring high (>95%), intermediate (68%), and low (20%) m.A3243G mutation. iNs demonstrated neuronal morphology with neurite outgrowth, branching, and dendritic spines. The heteroplasmy and deficiency of respiratory chain complexes were retained in MELAS iNs. High heteroplasmy elicited the elevation in ROS levels and the disruption of mitochondrial membrane potential. Furthermore, high and intermediate heteroplasmy led to the impairment of mitochondrial bioenergetics and a change in mitochondrial dynamics toward the fission and fragmentation of mitochondria, with a reduction in mitochondrial networks. Moreover, iNs derived from aged individuals manifested with mitochondrial fission. These results help us in understanding the impact of various heteroplasmic levels on mitochondrial bioenergetics and mitochondrial dynamics in neurons as the underlying pathomechanism of neurological manifestations of MELAS syndrome. Furthermore, these findings provide targets for further pharmacological approaches of mitochondrial diseases and validate iNs as a reliable platform for studies in neuronal aspects of aging, neurodegenerative disorders, and mitochondrial diseases.
Asunto(s)
Síndrome MELAS , Humanos , Anciano , Síndrome MELAS/genética , Heteroplasmia , ADN Mitocondrial/genética , Mitocondrias/metabolismo , Metabolismo Energético/genética , NeuronasRESUMEN
The autosomal recessive form of type II cutis laxa (ARCL II) is characterized by the appearance of redundant, inelastic skin with wrinkling, an aged look and additional variable systemic involvement including intrauterine growth retardation, failure to thrive, developmental delay, dysmorphism, osseous abnormality, and CNS manifestations. Several genetic defects have been found in patients and families with the clinical manifestations of ARCL II. Recently, mutations in PYCR1 have been linked to cutis laxa with progeroid features. We ascertained two siblings with of ARCL II born to non-consanguineous parents. Mutation analysis of PYCR1 revealed a novel single-base deletion (c.345delC) in exon 4 leading to frame-shift and premature stop of translation. The effect of this mutation results in a strong reduction of PYCR1 expression in skin fibroblasts from affected siblings. These two cases extend the genotypic spectrum of PYCR1-related ARCL II.
Asunto(s)
Envejecimiento Prematuro/genética , Cutis Laxo/genética , Predisposición Genética a la Enfermedad/genética , Pirrolina Carboxilato Reductasas/genética , Secuencia de Bases , Niño , Cutis Laxo/patología , Fibroblastos/metabolismo , Mutación del Sistema de Lectura/genética , Genes Recesivos , Humanos , Immunoblotting , Masculino , Datos de Secuencia Molecular , Pirrolina Carboxilato Reductasas/metabolismo , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ADN , Piel/patología , delta-1-Pirrolina-5-Carboxilato ReductasaRESUMEN
De Barsy syndrome (DBS) is characterized by progeroid features, ophthalmological abnormalities, intrauterine growth retardation, and cutis laxa. Recently, PYCR1 mutations were identified in cutis laxa with progeroid features. Herein, we report on a DBS patient born to a nonconsanguineous Chinese family. The exceptional observation of congenital glaucoma, aortic root dilatation, and idiopathic hypertrophic pyloric stenosis in this patient widened the range of symptoms that have been noted in DBS. Mutation analysis of PYCR1 revealed compound heterozygous PYCR1 mutations, including a p.P115fsX7 null mutation allele and a second allele with two missense mutations in cis: p.G248E and p.G297R. The effect of mutation results in a reduction of PYCR1 mRNA expression and PYCR1 protein expression in skin fibroblasts from the patient. The findings presented here suggest a mutation screening of PYCR1 and cardiovascular survey in patients with DBS.
Asunto(s)
Opacidad de la Córnea/genética , Cutis Laxo/genética , Heterocigoto , Discapacidad Intelectual/genética , Mutación , Fenotipo , Pirrolina Carboxilato Reductasas/genética , Anomalías Múltiples/genética , Secuencia de Bases , Niño , Preescolar , Opacidad de la Córnea/diagnóstico , Cutis Laxo/diagnóstico , Exones , Expresión Génica , Humanos , Discapacidad Intelectual/diagnóstico , Masculino , Pirrolina Carboxilato Reductasas/metabolismo , delta-1-Pirrolina-5-Carboxilato ReductasaRESUMEN
OBJECTIVE: To report the successful use of rasburicase in two children with hyperuricemia secondary to severe rhabdomyolysis. DESIGN: : Case report. SETTING: Pediatric intensive care unit in a freestanding quaternary hospital. PATIENTS: Two pediatric patients with severe rhabdomyolysis and hyperuricemia caused by ecstasy intoxication and exertional heat stroke. INTERVENTION: Use of a single low dose (6 mg) of rasburicase, a urate oxidase enzyme. MEASUREMENTS AND MAIN RESULTS: Rasburicase was administered on the first and second hospital days with a single low dose of 6 mg (0.086 mg/kg in patient A and 0.092 mg/kg in patient B). Within 24 hrs, the levels of serum uric acid in both patients decreased dramatically, and their creatinine levels decreased and urine output increased concurrently. Continuous improvements in the uric acid levels, creatinine levels, and urine output were noted during hospitalization. CONCLUSION: Rasburicase seems to be a safe and effective drug for improving hyperuricemia in patients with rhabdomyolysis and renal failure.
Asunto(s)
Lesión Renal Aguda/etiología , Supresores de la Gota/uso terapéutico , Alucinógenos/envenenamiento , Golpe de Calor/complicaciones , Hiperuricemia/tratamiento farmacológico , N-Metil-3,4-metilenodioxianfetamina/envenenamiento , Esfuerzo Físico/fisiología , Rabdomiólisis/complicaciones , Urato Oxidasa/uso terapéutico , Adolescente , Niño , Femenino , Supresores de la Gota/administración & dosificación , Humanos , Masculino , Rabdomiólisis/etiología , Rabdomiólisis/fisiopatología , Taiwán , Urato Oxidasa/administración & dosificaciónRESUMEN
BACKGROUND: To analyze the findings of cranial ultrasonographic screening in asymptomatic neonates and to assess the association between abnormal results and neurodevelopment. METHODS: We retrospectively reviewed the cranial ultrasonographic screening results of healthy neonates born between 35 and 42 weeks gestation at our hospital from October 2011 to October 2018. RESULTS: In total, 11,681 neonates underwent cranial ultrasonographic screening during the study period, and 9666 (82.7%) had normal results. Of 2015 neonates with abnormal findings, 294 had more than two abnormalities. The most common minor findings were subependymal cysts (8.99%), choroid plexus cysts (2.43%), lenticulostriate vasculopathy (2.34%), frontal horn cysts (1.80%), and enlarged cisterna magna (1.04%). Then, 33 (0.28%) neonates had major abnormalities, including cerebral hemorrhage, periventricular heterotopia, focal cortical dysplasia, anomalies of the corpus callosum, and vascular malformation. Of 1334 neonates who underwent serial clinical evaluations, 76 (5.69%) had neurodevelopmental disorders, including developmental delay, attention-deficit/hyperactivity disorder, and autistic spectrum disorder. CONCLUSION: The incidence rate of intracranial anomalies in healthy neonates was 17.3%, and about 5.69% had neurodevelopmental disorders. Cranial ultrasonographic screening has its own value in helping early detection of intracranial anomalies in healthy neonates, some of which have prognostic implications.