Six neonates with destructive brain lesions of fetal onset, diagnosed by radiological and neurophysiological studies, are reported from the Departments of Pediatrics, Neurology, Radiology, and Obstetrics and Gynecology, Magee-Womens Hospital, Pittsburgh, PA and Children’s Hospital of Pittsburgh. Initial diagnosis of cerebral lesions was made by fetal sonography in 2 patients and CT scan in 4 during the first 30 hours of life. No intrapartum difficulties were noted and 2 patients had definitive evidence of maternal and placental disease that preceded the onset of active labor. The neurological examinations were normal at birth, but 4 presented with isolated seizures at 8-30 hours of life and initial neonatal EEGs showed abnormalities. The authors recommend that cranial imaging and neurophysiological studies should be used during the first days of life for neonates believed to have cerebral lesions based on maternal sonography or isolated seizures. [1]

COMMENT. Cranial ultrasonography and CT studies during the first few days of life may document lesions occurring prenatally. Children with antepartal brain injury may be asymptomatic or exhibit few clinical signs during the neonatal period and may later develop cerebral palsy.