state-of-the-art-cranial-ultrasound-imaging-in-neonates

State of the Art Cranial Ultrasound Imaging in Neonates

Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a ...

Erasmus MC-Sophia Children's Hospital

The objective of this study was to evaluate clinical symptoms and findings on cranial ultrasound (CUS) in preterm infants with cerebellar haemorrhage through retrospective analysis of all preterm infants with a postnatal CUS or MRI diagnosis of cerebellar haemorrhage admitted in a tertiary care centre between January 2002 and June 2009. Fifteen infants were identified; median gestational age was 25 2/7 weeks and median birth weight 730 g. We discerned six types of haemorrhage: subarachnoid (n = 3), folial (n = 1), lobar (n = 9, of which 4 bilateral), giant lobar (n = 1, including vermis) and contusional (n = 1). Especially in infants with lobar cerebellar haemorrhage, CUS showed preceding or concurrent lateral ventricle dilatation, mostly without intraventricular haemorrhage (IVH). Thirteen infants suffered from notable, otherwise unexplained motor agitation in the days preceding the diagnosis. In conclusion, motor agitation may be a presenting symptom of cerebellar haemorrhage in preterm infants. Unexplained ventriculomegaly can be a first sign of cerebellar haemorrhage and should instigate sonographic exploration of the cerebellum.

The clinical presentation of preterm cerebellar haemorrhage.

To date, studies on neonatal stroke have mainly focused on cortical stroke. We have focused on perforator strokes, noncortical strokes in the arterial vascular perforator area. We sought to identify risk factors and evaluate clinical presentation and neuroimaging findings for neonatal perforator stroke, which seems to be under-recognized.

Risk factors, clinical presentation, and neuroimaging findings of neonatal perforator stroke.

Preterm infants are born during critical stages of brain development, in which the adaptive capacity of the fetus to extra-uterine environment is limited. Inadequate brain perfusion has been directly linked to preterm brain damage. Advanced high-frequency ultrasound probes and processing algorithms allow visualization of microvessels and depiction of regional variation. To assess whether visualization and flow velocity estimates of preterm cerebral perfusion using Doppler techniques are accurate, we conducted an in vitro experiment using a microvessel flow phantom.

Calibrating Doppler imaging of preterm intracerebral circulation using a microvessel flow phantom.

To investigate detection ability and feasibility of serial cranial ultrasonography (CUS) and early MRI in preterm brain injury.

Article	Year
The clinical presentation of preterm cerebellar haemorrhage. European journal of pediatrics\| PubMed ID: 20480179	2010
Risk factors, clinical presentation, and neuroimaging findings of neonatal perforator stroke. Stroke; a journal of cerebral circulation\| PubMed ID: 23723310	2013
Calibrating Doppler imaging of preterm intracerebral circulation using a microvessel flow phantom. Frontiers in human neuroscience\| PubMed ID: 25628560	2014
Serial cranial ultrasonography or early MRI for detecting preterm brain injury? Archives of disease in childhood. Fetal and neonatal edition\| PubMed ID: 25637006	2015

Ginette M. Ecury-Goossen

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