Paediatric cranial ultrasound: abnormalities of the brain in term neonates and young infants

Cranial ultrasound is a critical screening tool in the detection of cerebral abnormalities in term neonates and infants, and is complementary to other imaging modalities. This pictorial review illustrates the diverse central nervous system pathologies which can affect the term neonatal and infantile brain, including vascular abnormalities (hypoxic ischaemic injury, perinatal arterial ischaemic stroke, cerebral sinovenous thrombosis, vein of Galen aneurysmal malformations, subpial haemorrhage, and dural sinus malformations); infections (congenital (cytomegalovirus and toxoplasmosis) and bacterial meningoencephalitis); genetic disorders and malformations (callosal agenesis, tuberous sclerosis, developmental megalencephaly, lissencephaly-pachygyria, and grey matter heterotopia); tumours (choroid plexus papilloma, atypical teratoid/rhabdoid tumour, and desmoplastic infantile glioma) and trauma (birth-related, inflicted injury). Each condition is explored with a focus on its sonographic characteristics-some have rarely, if ever, been described on ultrasound. CRITICAL RELEVANCE STATEMENT: Through this case review, we illustrate various pathologies affecting the term neonatal and infantile brain, including vascular lesions, infection, genetic disorders/malformations, tumours and trauma: some of these pathologies have rarely, if ever, been described on CUS. KEY POINTS: Cranial ultrasound (CUS) is a critical screening tool for the term brain. Many term neonatal and infantile pathologies can be detected on CUS. Some of the pathologies illustrated in this paper have rarely been described on US.