Real-time sonography of the brain through the anterior fontanelle

Noninvasive, rapid evaluation of the neonate and young infants with reproducible results is feasible with real-time cranial sonography through the anterior fontanelle. Cerebral anatomy in coronal and sagittal planes is visualized, and the entire ventricular system and adjacent brain parenchyma are identified. This rapid (5-10 min) procedure can be done at/in the incubator making transport of sick neonates unnecessary, thus preserving their thermal stability. Images are recorded on videotape and "hard copy" is obtained afterward. Ventricular size, intracranial hemorrhage (both intraventricular and parenchymal), abnormalities of the the ventricular system, subdural effusion, and fluid-filled lesions are recognized by the usual sonographic criteria. In addition, "solid" parenchymal lesions such as diffuse hemangiomas and brain tumors are depicted as changes in sonographic parenchymal architecture.