Detection of extracerebral fluid collections by real-time sector scanning through the anterior fontanelle

The developmental changes of the extracerebral space seen on ultrasonography in neonates and infants

Ultrasonographic examination was performed in 70 healthy neonates and infants using a real-time sector scanner array machine with a 7.5-MHz transducer and a 4 cm waterbag. The skin, subcutaneous tissue, dura mater, interhemispheric fissure, gyri, sulci and sagittal sinus could be clearly visualized on ultrasonography (US), and the distance from the dura mater to the brain surface was determined. The extracerebral space under the anterior fontanel increased until 3 months after birth, and decreased gradually from 3 months to 12 months. The width and structure of the extracerebral space seen on US can be useful as parameters for assessing the process of brain growth and for detecting extra- and intracerebral pathologies in neonates and infants.

Sonographic appearance of extra-axial fluid collections in the infant: further observations

Extra-axial fluid collections were identified in six infants by transfontanelle cranial sonography. Confirmatory computer tomography (CT) scans were performed following the sonograms in five of these patients. These extra-axial fluid collections were varied in appearance and could be divided into two types depending on their sonographic characteristics. The first group consisted of large, usually concave anechoic collections and the second of small extra-axial fluid collections best seen in the interhemispheric fissure. The large collections were easily identified using a routine 5 MHz transducer system. The smaller collections were not well visualized with a 5 MHz system and required a 7.5 MHz transducer to identify the fluid in the interhemispheric fissure. Additionally, the lateral extent of these small collections could not be visualized through the anterior fontanelle using either transducer and CT was required for definitive evaluation of their lateral extent.

Ultrasonic detection of subdural collections

Subdural collections in infants are common complications of meningitis, trauma and post surgical procedures. Careful ultrasonic examination via the anterior fontanelle is a reliable method of demonstrating these collections. It has an accuracy comparable to computed tomography and is our first line of investigation.

Ultrasound in the evaluation of hypoxic-ischemic injury and intracranial hemorrhage in neonates: the state of the art

The ultrasonic diagnosis of hypoxic-ischemic injury and intracranial hemorrhage in neonates is reviewed. The technical and pertinent anatomical data are presented. The need to diagnose parenchymal lesions is emphasized. A sonographic classification as well as current recommendations for evaluation of intracranial contents in neonates suspected of hypoxic-ischemic injury and/or hemorrhage are presented.