We then present clinical and screening indications for cranial sonography in the neonate, emphasizing the pathogenesis and classification of intracranial. Normal Sagittal. Normal Coronal. Neonatal brain sagittal midline, Neonatal head coronal anterior. Normal sagittal at the 3rd and 4th ventricles. Normal anterior. Abstract. OBJECTIVE To assess the abilities of doctors to interpret neonatal cranial ultrasound scans. DESIGN AND SETTING High resolution scanned images.


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The fine network of vessels the germinal matrix on the floor of the anterior horn of the lateral ventricles the ependyma are extremely fragile.


If there is any hypoxic neonatal cranial ultrasonography, the reactive increase neonatal cranial ultrasonography blood pressure can result in a haemorrhage of these vessels.

Usually assessed at day 1 and again at day 7. Even with a large fontanelle, the peripheral extremes of the brain are obscured from view. Primarily a small footprint, wide sector, mid. Ideally a specific MHz vector probe however a trans-vaginal probe also provides excellent imaging.

Neonatal cranial sonography: A concise review for clinicians

A TV probe can be ergonomically difficult to use for some operators and awkward to ft in a humidicrib. You may also require a high frequency linear array to assess superficial structures and a curvilinear probe for axial trans-temporal images.

A warm room with warm gel. neonatal cranial ultrasonography

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It is therefore important to understand the relationship of the anatomy to the image provided. Images below detail the standard set of images taken. The accompanying images are from a 30 week neonatal cranial ultrasonography with normal appearing anatomy.

Images are usually taken through the anterior fontanelle. The posterior fontanelle can be used if needed, and axial images are occasionally taken through the temporal bone. In the coronal plane, a series of neonatal cranial ultrasonography are taken through the frontal lobes, more posteriorly through the ventricles and thalami, then along the plane of the choroid plexus, then superior to that.

The sagittal images are initially taken in the midline, with images then taken on both sides at the level of the lateral ventricles then periventricular areas. For the purposes of conserving space on this page, the left sagittal images have been omitted.

Diagrams modified from Rennie JM.

Neonatal cranial sonography: A concise review for clinicians

Cambridge University Press Used with permission from the author. Do not limit yourself to only one transducer or only one acustic window figure.


Generally the large fontanel is used as acoustic window. The small fontanel however is a good window to the occipital lobes.

Normal neonatal head ultrasound

This can be usefull in patients with borderline hyperechogenicity in these areas. Disadvantages of US are: It neonatal cranial ultrasonography a white matter disease that affects the periventricular zones.

In prematures this white matter zone is a watershed zone between deep and superficial vessels. Until recently ischemia was thought to be the single cause of PVL, but probably other causes infection, vasculitis play an additional role.

PVL presents as areas of increased periventricular echogenicity.

Neonatal Cranial Ultrasound Standard Views

Normally the neonatal cranial ultrasonography of the periventricular white matter should be less than the echogenicity of the choroid plexus.

Detection of PVL is important because a significant percentage of surviving premature infants with PVL develop cerebral palsy, intellectual impairment or visual disturbances.

Regular sonographic examination is mandatory as cysts in PVL can develop as long as 4 weeks after birth especially in prematures Neonatal cranial ultrasonography ultrasonographic findings may be normal in patients who go on to develop clinical and delayed imaging findings of PVL.

A good protocol is US-examination at least once a week until discharge? Sagittal image of a child with PVL grade 1 PVL grade 1 PVL is diagnosed as grade 1 if there are areas of increased periventricular echogenicity without any cyst formation persisting for more than 7 days.