Cranial ultrasounds

CHAPTER 19 Cranial ultrasounds



Mark Davies, David Cartwright



Findings


A routine head ultrasound (US) is recommended for all babies <1750 g or <32 weeks gestational age (GA), on days 3 and 10. A routine late head US is recommended at 6 weeks (or 4 weeks of age if >1200 g).


Different schemes will operate in different hospitals. Some units will do a routine US on day 1. Some will limit routine scans to lower birth weights and GAs.



Intraventricular haemorrhage (IVH)


IVH is graded by the worst IVH on either side.



















Grade Features
1 Germinal matrix or sub-ependymal bleed, no intraventricular blood
2 Grade 1 plus intraventricular blood, no ventricular dilatation
3 Grade 2 plus ventricular dilatation
4 Grade 3 plus haemorrhage in the periventricular area

A Grade 4 bleed is not an extension of a Grade 3 bleed. It is probably a haemorrhagic–ischaemic lesion secondary to venous congestion (venous infarction) in the periventricular region due to the germinal matrix bleed.



Periventricular echogenicity (PVE)



• This may be due to a Grade 4 IVH and may lead to porencephaly.

• When not associated with IVH, it is usually an area of ischaemia/infarction and represents white-matter injury. The US appearance may resolve completely or become cystic periventricular leucomalacia.

• PVE that persists >7–14 days but does not become cystic increases the risk of cerebral palsy (CP) to ∼5–10%.
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Jul 18, 2016 | Posted by in PEDIATRICS | Comments Off on Cranial ultrasounds

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