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The posterior fontanelle: a neglected acoustic window
1Department of Neonatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Neuropediatrics
|April 1, 1996
Summary
Using the posterior fontanelle as a second acoustic window in cranial ultrasound can reveal extensive brain damage in unstable newborns. This method aids in diagnosing hypoxic ischaemic encephalopathy in neonates too sick for MRI.
Area of Science:
- Neonatal neurology
- Pediatric neuroimaging
Background:
- Cranial ultrasound is a non-invasive imaging technique used in neonates.
- The posterior fontanelle is typically not used as a primary acoustic window.
Observation:
- Routine use of the posterior fontanelle as a second acoustic window provided additional diagnostic information in four infants.
- Three of these infants were full-term neonates diagnosed with hypoxic ischaemic encephalopathy.
Findings:
- Cranial ultrasound through the posterior fontanelle effectively visualizes extensive occipital subcortical white matter and/or cortical damage.
- This technique is particularly useful for neonates who are too unstable for transport to magnetic resonance imaging (MRI) units.
Implications:
- This approach enhances the diagnostic capabilities of cranial ultrasound in critically ill newborns.
- It offers a valuable alternative for assessing brain injury in neonates when MRI is not feasible.
- Routine utilization of the posterior fontanelle may improve early detection and management of neonatal brain injury.