Cerebral transfontanelle ultrasonography has been making many progress for ten years, with the grey scale of new echographs. We report here our experience. The technique is now standardized: we use a high resolution realtime scanner with a 5 MHz transducer placed directly over the fontanella. The flexible cable permits the examination of preterm infants in incubator. After the description of normal echoanatomy, we give examples of the most frequent pathology observed: hydrocephalus, intracranial haemorrhage, periventricular leukomalacia, corpus callosum lipoma, brains dysraphism, Dandy Walker malformation.
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Anesth Pain Med (Seoul)
October 2024
Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
Cerebral blood flow (CBF) plays a vital role in delivering cerebral oxygen, and the accurate assessment of CBF is crucial for the intraoperative management of critically ill infants. Although the direct measurement of CBF is challenging, CBF velocity (CBFV) can be assessed using transcranial Doppler. Recent advances in point-of-care ultrasound have introduced brain ultrasound as a feasible intraoperative option, in which transfontanelle ultrasonography (TFU) has been applied to measure the CBFV through the anterior fontanelle.
View Article and Find Full Text PDFPhotoacoustics
October 2023
Richard and Loan Hill Department of Bioengineering, University of Illinois at Chicago, Chicago, IL, United States.
Intraventricular (IVH) and periventricular (PVH) hemorrhages in preterm neonates are common because the periventricular blood vessels are still developing up to 36 weeks and are fragile. Currently, transfontanelle ultrasound (US) imaging is utilized for screening for IVH and PVH, largely through the anterior fontanelle. However for mild hemorrhages, inconclusive diagnoses are common, leading to failure to detect IVH/PVH or, when other clinical symptoms are present, use of second stage neuroimaging modalities requiring transport of vulnerable patients.
View Article and Find Full Text PDFPhotoacoustics
August 2023
University of Illinois at Chicago, Department of Biomedical Engineering, Chicago, IL, United States.
We have developed and optimized an imaging system to study and improve the detection of brain hemorrhage and to quantify oxygenation. Since this system is intended to be used for brain imaging in neonates through the skull opening, i.e.
View Article and Find Full Text PDFThe case of an infantile cerebral cavernous malformation detected by transfontanelle cranial ultrasonography. Infantile cerebral cavernous malformations tend to cause more major bleeding compared to those in older groups, so early detection and treatment are crucial. Cranial ultrasonography can contribute to the early diagnosis of infantile cerebral cavernous malformations.
View Article and Find Full Text PDFPLoS One
March 2023
Department of Neurosurgery, Goethe-University Hospital, Frankfurt am Main, Germany.
Introduction: Ventriculoperitoneal shunt (VPS) with adjustable differential pressure valves are commonly used to treat infants with hydrocephalus avoiding shunt related under- or overdrainage. The aim of this study was to analyse the influence of VPS adjustable differential pressure valve on the head circumference (HC) and ventricular size (VS) stabilization in infants with post intraventricular haemorrhage, acquired and congenital hydrocephali.
Methods: Forty-three hydrocephalic infants under 6 months old were prospectively included between 2014 and 2018.
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