Sonography of the Neonatal Brain

Question 1

When does the anterior fontanelle start to close?

Answer 1

9 months

Question 2

When is the anterior fontanelle completely closed?

Answer 2

15 months

Question 3

At the level of what structure is the coronal view 1 taken?

Answer 3

Orbits

Question 4

At the level of what structures is the coronal view 2 taken?

Answer 4

Frontal horns of the lateral ventricles with CSP in between

Question 5

What structures are well visualized in the coronal view 3?

Answer 5

Frontal horns of the ventricle

Question 6

What coronal image is NOT always taken?

Answer 6

3

Question 7

At the level of what structures is the coronal view 4 taken?

Answer 7

Foramen of Monroe - lateral ventricles into the 3rd ventricle

Question 8

At what level in the coronal view of a pediatric brain are the lateral ventricles measured?

Answer 8

View 4 - where we can see the lateral ventricles and 3rd ventricle and sylvian fissures

Question 9

At the level of what structures is the coronal view 5 taken?

Answer 9

1. CP - appears as a white echogenic line
2. Sylvian fissures
3. Tentorium
4. Cerebellum
5. CM

Question 10

At the level of what structures is the coronal view 6 taken?

Answer 10

Quadrigeminal cistern AKA superior cistern (star shaped)

Question 11

At the level of what structures is the coronal view 7 taken?

Answer 11

1. Trigones of lateral ventricles
2. The glomi - largest part of the CP
3. We must compare the peri-ventricular area to the CP. Want to make sure the CP is brighter than peri-ventricular area

Question 12

At the level of what structures is the coronal view 8 taken?

Answer 12

1. Echogenic peri-ventricular white matter
2. Posterior aspect of IH fissure

Question 13

What structures are we looking for in SAG image 1?

Answer 13

1. Echogenic corpus callosum
2. Use CD to determine presence of pericallosal artery

Question 14

The absence of what structure in SAG image 1 suggests pathology?

Answer 14

CM

Question 15

What structures are we looking for in SAG image 2?

Answer 15

Caudothalamic groove - a common site for hemorrhage in premies (germinal matrix)

Question 16

What structures are we looking for in SAG image 3?

Answer 16

Lateral ventricle - make sure CP tapers at caudothalamic groove

Question 17

What structures are we looking for in SAG image 4?

Answer 17

Want to see the glomus of the CP filling the trigone AKA atrium of the lateral ventricle

Question 18

What structures are we looking for in SAG image 5?

Answer 18

Sylvian fissures - separates parietal and frontal lobe from temporal lobe

Question 19

What window would we use to image the posterior fossa more clearly?

Answer 19

Mastoid fontanelle / posterolateral (behind the ear)

Question 20

What are we looking for when imaging the occipital fontanelle?

Answer 20

Can visualize the occipital horn of the lateral ventricle and is a possible site for a bleed - determine if there is any debris signifying a bleed

Question 21

What are we trying to determine when imaging the falx cerebri from the superior sagittal sinus?

Answer 21

Patency of the sinus

Question 22

What artery can be seen pulsating through the sylvian fissure?

Answer 22

Branches of MCA