Radiographs

by Zev Gershon MD, JD specializes in Cerebral Palsy cases.
Radiographs: ultrasound, CAT scans and MRI’s can help time when an injury occurred, if it occurred during labor and delivery.

An ultrasound is a type of radiograph that is done through sonographic waves. They usually do an ultrasound after birth for a child who is suffering from seizures, and that helps determine if there is bleeding in the brain, or edema- swelling in the brain, or other factors that can be causing the baby to have seizures. The ultrasound is best done right after birth.

Another mode is a CAT scan. A CAT scan uses different types of radiographic waves to look at the baby’s brain, and it too can be used to time an injury. A CAT scan is usually done during the first week of life but it can continue thereafter to look at the different parts of the brain. Specifically you are looking to see if there is swelling of the brain, because a lack of oxygen at birth can result in swelling of the brain. And a CAT scan is a very good tool to look for edema – swelling of the brain. Specifically edema will rise shortly after a hypoxic insult, and within a day or two, will become maximal. So by 48 hours you should see a lot of swelling in the brain. Sometimes the swelling lasts as long as 3 or 4 days and then begins to come down. Many times you see the swelling within 6 to 12 hours after the insult. But it follows a definite pattern: it rises, peaks and comes down. And the CAT scan is a very good tool for measuring that.

The final tool they have for examining if there is injury to the brain is called an MRI. An MRI uses magnetic type waves to determine if there has been an injury. It focuses on different parts of the brain and can see various parts of the brain more accurately than a CAT scan.

Using these 3 tools, ultrasound, CAT scan and MRI, if a hypoxic ischemic injury, that is a lack of oxygen or a lack of blood flow occurred during labor and delivery, these 3 tools can help determine when that injury occurred.