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Abstract

Intraventricular Hemorrhage (IVH) is a major neurological complication of prematurity, affecting primarily preterm neonates born before 32 weeks of gestation or with very low birth weight. Despite its contribution to neonatal morbidity and mortality, it has potential long term neurodevelopmental consequences such as cerebral palsy, cognitive impairment and hydrocephalus. Early and accurate detection is critical to the initiation of timely interventions and to improving neurological outcomes. Because of noninvasiveness, portability, cost effectiveness and safety profile, cranial ultrasound (CUS) has become the preferred imaging modality for early detection of IVH in Neonatal Intensive Care Units (NICUs). Current evidence on the role of cranial ultrasound in diagnosing, grading and monitoring IVH in preterm infants is synthesized in this review. The technical aspects, optimal timing and frequency of ultrasound screening are examined and its diagnostic accuracy compared to other neuroimaging modalities such as Magnetic Resonance Imaging (MRI) and Computed Tomography (CT). In addition, the prognostic value of ultrasound findings is discussed, including in relation to the Papile grading system and emerging innovations such as high frequency transducers, Doppler techniques and AI based interpretation tools are evaluated. Critical appraisal of limitations such as operator dependency and decreased sensitivity in posterior fossa assessment, is performed. Cranial ultrasound is an important tool for early detection and management of IVH and improving outcomes in vulnerable preterm populations.