What is the role of imaging studies in the evaluation of neonatal abstinence syndrome (NAS)?

Updated: Dec 20, 2017
  • Author: Ashraf H Hamdan, MD, MBBCh, MSc, MRCP, FAAP; Chief Editor: Santina A Zanelli, MD  more...
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Answer

Cranial ultrasonography is not routinely recommended, but literature is suggestive of central nervous system abnormalities, including hemorrhagic ischemic lesions in some drug-exposed infants. [55]

Evidence is insufficient to support a mandate for cranial ultrasonography in all cocaine-exposed infants. van Huis et al studied 154 neonates exposed to cocaine in utero and found that none of the infants had severe abnormalities on cranial ultrasonography. [56] Also, the detected abnormalities were not correlated with the duration or maximum amount of cocaine use. Given these findings, the investigators recommended that routine cranial ultrasonography in infants exposed to cocaine in utero is not warranted. [56] However, special consideration should be given to specific neuroimaging of cocaine-exposed preterm infants, infants whose head circumference falls below the 10th percentile on standardized fetal growth curves, and infants with abnormal neurologic signs, neurobehavioral dysfunction, or seizure activity. [57]


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