Experience on Transfontanelle Neurosonography in Kano, Nigeria: a preliminary report

To retrospectively audit and analyse all the Transfontanelle Neurosonographic scans performed at the Aminu Kano Teaching Hospital (AKTH), between January to September, 2004.

Information on the gray scale appearance of the ventricles, cerebral and cerebellar parenchyma, extra axial fluid spaces, status of the sulci and gyri and the echogenic internal outline of the bony skull vault was extracted from the records of all the Transfontanelle neurosonographic scans performed at the specialist Ultrasound clinic of the AKTH, between January to September, 2004.

Eighteen infants were scanned, and 8 (44.4%) of them were neonates. Meningitis (9 patients) and increasing head size (7 patients) were the commonest clinical indication for referral. Communicating hydrocephalus was the only known complication seen in 4(44.4%) of the post meningitic patients. While in the increasing head size group, congenital malformations such as Aqueductal stenosis and Arachnoid cyst of the quadrigeminal cistern as well as hydrocephalus predominates (4 out of 7 patients). The last 2 patients referred on account of severe birth asphyxia and swollen occiput showed no abnormality and occipital meningocoele respectively.

This study confirms the earlier notion of the pre-eminence of infection as compared to congenital malformation as the leading cause of infant morbidity in developing nations. It also emphasises the value of Transfontanelle neurosonography as an excellent, non-invasive, inexpensive, rapid and safe imaging modality for the evaluation of the pathologic conditions of infants' brain.