الفهرس 
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Abstract
Hypoxic ischemic encephalopathy (HIE) in pre-term neonates increases the incidence and prevalence of occurrence and it’s also one of the most common causes of children hand-cape or cerebral palsy in severe cases. The purpose of this study was to assess the accuracy of trans-cranial Doppler Ultrasonography (TCD) of the middle cerebral artery for early prediction of the severity of the disease and the late outcome will occurs and suggestion of an early radiological grading of the severity of hypoxic ischemic encephalopathy (HIE) by trans-cranial ultrasound and pulsed Doppler.
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TCD was done to the cases within the first 10 days of the neonatal life by using endocavitary probe, small curved probe and a single crystal probe through the anterior, posterior fontanels and temporal foramen to grade the cases according to periventricular leukolamalacea (PVL) grading and record of resistive index of the middle cerebral artery (MCA) by pulsed Doppler. Evaluation of TCD performance within the first 10 days of the neonatal life correlates with the ones obtained in the sixth month of life in infant with hypoxic ischemic encephalopathy (HIE).
This study shows in the results a specific relation between the average resistive index (RI) of the middle cerebral artery (MCA) and Apgar score showing P value >0.0001and (85% sensitivity & 95.2% specificity). Another relation between the average resistive index (RI) of the middle cerebral artery (MCA) and PeriVentricular leukolamalacea (PVL) showing P value >0.0001and (73.3% sensitivity & 90.9% specificity). A relation between the average resistive index (RI) of the middle cerebral artery (MCA) and Language (developmental milestones) showing P value = 0.0004and (66.7% sensitivity & 100% specificity). There is also another relation between Periventricular leukolamalacea (PVL) vs. Apgar score showing P value = 0.005and (95% sensitivity & 47.6% specificit