Neonatal Brain Ultrasound Normal Vs Abnormal Images | Full Term Infant & Premature Newborn Head USG

Summary

Dr. Sam's video delves into neonatal brain ultrasound, focusing on its importance for premature and high-risk infants. It explains the normal brain's appearance in both full-term and premature infants, highlighting key structures like the interhemispheric fissure and the Sylvian fissure. The video also covers various brain pathologies, including hydrocephalus, intracranial hemorrhages, and malformations like Chiari and Dandy-Walker. It discusses the significance of the choroid plexus and the implications of conditions like lissencephaly and porencephaly. The informative content is tailored for medical professionals and those interested in neonatal neurology.

Takeaways

• 🧠 Neonatal brain ultrasounds are crucial for assessing the brain health of premature and high-risk infants.
• 👶 The coronal view is most commonly used in neonatal ultrasounds as it provides detailed images of the brain's structures.
• 🌟 In normal full-term infants, the ultrasound shows distinct features like the interhemispheric fissure, frontal horns, and Sylvian fissure.
• 👶🏻 Premature infants typically have larger lateral ventricles and fewer prominent sulci compared to full-term infants.
• 💧 Hydrocephalus is characterized by the abnormal accumulation of cerebrospinal fluid, leading to enlarged ventricles.
• 🩸 Intracranial hemorrhages, common in premature infants, are often germinal matrix hemorrhages and can be graded from one to four based on severity.
• 🧬 Chiari malformations involve the downward displacement of the cerebellar tonsils and can affect the shape and size of the ventricles and cerebellum.
• 🧲 The choroid plexus, responsible for producing cerebrospinal fluid, can develop cysts or lipomas, which appear as fluid or hyperechoic masses on ultrasound.
• 🧬 Agenesis of the corpus callosum presents with parallel and enlarged lateral ventricles, often with a high-riding third ventricle.
• 🧲 Dandy-Walker malformation is identified by an abnormally wide connection between the fourth ventricle and the cisterna magna, with a dilated fourth ventricle.
• 🩺 Conditions like lissencephaly (smooth brain) and schizencephaly (brain clefts) are characterized by the absence of normal brain sulci and can be distinguished by their ultrasound features.

Q & A

What is the primary purpose of neonatal brain ultrasound?

Neonatal brain ultrasound is primarily performed on premature and high-risk infants to assess brain structures and identify abnormalities such as hemorrhages or enlarged ventricles.

What are the key differences in brain structure between full-term and premature infants on ultrasound?

In premature infants, the lateral ventricles are usually larger, and the sulci are less prominent compared to full-term infants, whose brain structures are more developed with more pronounced sulci.

What is the interhemispheric fissure, and how is it visualized on a neonatal brain ultrasound?

The interhemispheric fissure is a hyper-echoic line seen in coronal views of the brain, separating the two cerebral hemispheres.

What are the grades of germinal matrix hemorrhage in neonates, and how are they characterized?

Germinal matrix hemorrhages are graded from 1 to 4. Grade 1: Hemorrhage outside the ventricle. Grade 2: Hemorrhage extends into the ventricles without dilating them. Grade 3: Hemorrhage extends into the ventricles with dilation (ventriculomegaly). Grade 4: Hemorrhage extends into the brain tissue.

What are some characteristic features of hydrocephalus on neonatal brain ultrasound?

Hydrocephalus is characterized by abnormal accumulation of cerebrospinal fluid (CSF) leading to enlarged lateral ventricles, and in severe cases, dilated temporal horns.

What is the significance of a frontal horn cyst in neonates, and how is it detected?

A frontal horn cyst, also known as coact cyst, is usually a normal variant caused by folding of the frontal horn. It appears as a small cystic structure near the frontal horn on ultrasound.

What are the key features of Chiari II malformation visible on neonatal ultrasound?

Chiari II malformation is characterized by downward displacement of the fourth ventricle, enlargement of the third ventricle, obliteration of the cisterna magna, and a batwing configuration of the lateral ventricles.

How can agenesis of the corpus callosum be identified on neonatal brain ultrasound?

In agenesis of the corpus callosum, the lateral ventricles appear parallel, the third ventricle is displaced upward, and the corpus callosum is absent.

What is porencephaly, and how is it visualized on ultrasound?

Porencephaly is a condition where a cystic lesion is seen communicating with the ventricles. This cystic space connects with the ventricles and can be detected as a fluid-filled area on ultrasound.

What are the characteristics of septo-optic dysplasia on neonatal brain ultrasound?

Septo-optic dysplasia is the mildest form of holoprosencephaly, where the septum pellucidum is absent, and there is fusion of the frontal horns of the lateral ventricles. This leads to a single large ventricle instead of two separate ones.