"As with all ultrasound studies, head ultrasound is highly operator-dependent. This is not a true disadvantage as such but does necessitate that the radiographer performing the examination be well-trained in the acquisition technique, know how to utilise the available ultrasound machine(s), and be knowledgeable in intracranial anatomy and pathology, so as not to miss any significant finding."
"A basic routine scan is performed through the anterior fontanelle. To be sure, the brain of an extremely premature neonate (i.e. 28 weeks or less) will appear less developed than that of a term neonate, including less convoluted gyri and shallower sulci; the following should only serve as a rough guide.On a coronal (transverse) scan, the transducer is first angulated anteriorly, then gradually rotated posteriorly. The following structures should be sought and assessed 1:"
"level of frontal horns of lateral ventricles: frontal lobes, interhemispheric fissure, corpus callosum, frontal horns, cavum septi pellucidi, caudate nucleus, basal ganglia, temporal poles, Sylvian fissures"
"level of the foramen of Monro: frontal lobes, interhemispheric fissure, cingulate sulcus, corpus callosum, frontal horns and cavum septi pellucidi, choroid plexus in ventricles, caudate nucleus, basal ganglia, temporal lobes, Sylvian fissures"
"midsagittal: cingulate sulcus, corpus callosum, cavum septi pellucidi, cavum vergae (premature neonates or variant), third ventricle, fornix, midbrain, pons, medulla, cerebellar vermis, calcarine fissure, parieto-occipital fissure, quadrigeminal plate, fourth ventricle, cisterna magna, interpeduncular cistern, Sylvian aqueduct"
"The grey matter (cerebral cortex and basal ganglia) is hypoechoic while white matter is hyperechoic on ultrasound 7. In preterm babies born before 24 weeks, the cerebral cortex is usually smooth with only Sylvian fissures exhibited. Smooth cerebral cortex at this age should not be confused with lissencephaly. Parietooccipital fissure and cingulate sulci started to appear between 24 to 28 weeks of gestation. Branching of sulci appears at 30 weeks of gestation and continues until the baby is term 8."
"mobility, i.e. bedside scanning at the NICU and neonatal ward"
"a phased array transducer can be used if the fontanelle is small, e.g. at a later age in infancy, but has a narrower field of view and is generally less favoured"
Expected headings
"Advantages"
"Disadvantages"
"Indications"
"Approach"
"Transducers"
"Protocol"
"For a routine scan, the anterior (bregmatic) fontanelle serves as the acoustic window. Additional acoustic windows, used for visualising specific intracranial structures: the posterior (lambdoid) fontanelle, mastoid fontanelle, squamosal part of the temporal bone (i.e. temporal window), foramen magnum, coronal suture, and squamosal sutures."
"level of frontal horns of lateral ventricles: frontal lobes, interhemispheric fissure, corpus callosum, frontal horns, cavum septi pellucidi, caudate nucleus, basal ganglia, temporal poles, Sylvian fissures"
"level of the foramen of Monro: frontal lobes, interhemispheric fissure, cingulate sulcus, corpus callosum, frontal horns and cavum septi pellucidi, choroid plexus in ventricles, caudate nucleus, basal ganglia, temporal lobes, Sylvian fissures"
"level of the bodies of the lateral ventricles: interhemispheric fissure, corpus callosum, bodies of lateral ventricles with choroid plexus, third ventricle, caudate nucleus, basal ganglia, temporal horns of lateral ventricles, parahippocampal gyrus, parietal lobes, temporal lobes, Sylvian fissures, midbrain, tentorium cerebelli, cerebellar hemispheres and vermis"
"level of the trigones of the lateral ventricles: interhemispheric fissure, cavum vergae (in preterm neonates or as an anatomical variant), corpus callosum, trigones of the lateral ventricles with choroid plexus, parietal lobes, occipital lobes, calcarine fissure"
"midsagittal: cingulate sulcus, corpus callosum, cavum septi pellucidi, cavum vergae (premature neonates or variant), third ventricle, fornix, midbrain, pons, medulla, cerebellar vermis, calcarine fissure, parieto-occipital fissure, quadrigeminal plate, fourth ventricle, cisterna magna, interpeduncular cistern, Sylvian aqueduct"
"parasagittal plane though the insula: frontal lobe, temporal lobe, Sylvian fissure, parietal lobe, occipital lobe, insular cortex and sulci (in premature neonates, the latter gradually become visible as the infant matures), precentral, central, and postcentral sulci"
"parasagittal plane though the (right/left) lateral ventricle: frontal lobe, caudate nucleus, basal ganglia, thalamus, temporal lobe, cingulate sulcus, lateral ventricle - frontal horn, body, occipital horn, and temporal horn, choroid plexus; parahippocampal gyrus, cerebellar hemisphere, parietal lobe, parieto-occipital fissure, occipital lobe"
"A basic routine scan is performed through the anterior fontanelle. To be sure, the brain of an extremely premature neonate (i.e. 28 weeks or less) will appear less developed than that of a term neonate, including less convoluted gyri and shallower sulci; the following should only serve as a rough guide.On a coronal (transverse) scan, the transducer is first angulated anteriorly, then gradually rotated posteriorly. The following structures should be sought and assessed 1:"
"parasagittal plane though the (right/left) lateral ventricle: frontal lobe, caudate nucleus, basal ganglia, thalamus, temporal lobe, cingulate sulcus, lateral ventricle - frontal horn, body, occipital horn, and temporal horn, choroid plexus; parahippocampal gyrus, cerebellar hemisphere, parietal lobe, parieto-occipital fissure, occipital lobe"