Cribside Neurosonography: Real-Time Sonography for Intracranial Investigation of the Neonate

Abstract

A prospective study was made of 94 real-time sonographic sector scans of 56 neonates in a 6 month period. The examinations were performed using the anterior fontanelle as an acoustic window. In 17 cases, computed tomography (CT) head scans were available for comparison. In no case did the CT and sonographic examination disagree as to the size of the lateral ventricles. Abnormalities detected by sonography include ventriculomegaly, intracerebral hematomas, a congenital glioma, and several cystic lesions. Sonographic sector scanning produces excellent, detailed images of dilated lateral and third ventricles, uses no ionizing radiation, is less expensive than CT, and can be performed in the isolette, minimizing the risk of hypoxia and hypothermia. At Methodist Hospital Graduate Medical Center, sonography has replaced CT as the initial method of investigation of ventricular size. CT plays a complementary role in the evaluation of the posterior fossa, intracranial hemorrhage, and mass lesions.