Purpose or Case Report: Transfontanelle cranial ultrasound is widely used in the neonatal setting to screen for abnormalities, particularly in the neonatal and cardiac intensive care unit settings. Radiologists and sonographers are typically very familiar with the ultrasound appearance of germinal matrix hemorrhage in premature infants. However, other abnormalities can also be very well seen sonographically, but may be underappreciated and therefore underreported. Under recognition may delay appropriate therapy these infants. The purpose of this educational review is to demonstrate the sonographic findings in a variety of neonatal intracranial abnormities including ischemia, hemorrhage, as well as developmental and anatomical anomalies, and to compare them with what may be the more familiar cross sectional appearance, including CT and MRI.
Methods & Materials: An institutional review was conducted to identify neonatal patients with abnormal head ultrasounds and follow-up cross sectional imaging. Imaging was compared with clinical symptoms, treatment, and clinical course when available.
Results: A broad range of cases are presented including, germinal matrix, intraparenchymal, subdural, basal ganglia, and thalamic hemorrhage, as well as ischemia and dural venous sinus thrombosis. Additionally, sonographic findings of intracranial malformations are demonstrated including agenesis of the corpus callosum, holoprosencephaly, Dandy Walker variants, Chiari II, aqueductal stenosis with hydrocephalus, and hydranencephaly.
Conclusions: Multiple abnormalities can be well seen and diagnosed with cranial ultrasound. Knowledge of the sonographic appearance of these anomalies compared with the more typically seen MRI can aid the radiologist and sonographer in detection and therefore improve patient care by expediting appropriate treatment when applicable.