Overview of Neurosonography Assessment, Protocols, and Interpretation
An ultrasound is an excellent method for examining a baby’s brain. Its great advantage is that it is portable, meaning it can be conveniently moved and used right by the baby’s bed. It’s often the first thing doctors use to look at a baby’s brain and spot any potential health issues. It can help identify problems such as birth defects, brain bleeds, poor blood supply to the brain, and a condition called hydrocephalus, which is a buildup of fluid in the brain. This tool is particularly useful for checking the health of premature babies who are unwell.
Why do People Need Neurosonography Assessment, Protocols, and Interpretation
An MRI scan can be used for a variety of medical issues. Here are some of the reasons your doctor might schedule one for you:
1. If your doctor suspects or has detected birth defects in the brain before birth, they might request an MRI to get a better look.
2. If you have experienced a brain bleed or there’s a possibility of one, an MRI can be used to diagnose it and monitor its progression.
3. If there’s a suspicion of inadequate blood flow to the brain, an MRI can help confirm the problem – this is referred to as intracranial ischemia.
4. If there’s an excessive build-up of fluid in the brain, medically known as hydrocephalus, an MRI can be used to diagnose that.
5. If you are on extracorporeal membrane oxygenation therapy (ECMO) – a treatment that uses an artificial lung to circulate your blood, your doctor could order an MRI.
6. If your doctor suspects an infection that was present at birth, an MRI can help identify it.
7. If you have or your doctor suspects you have brain tumors, an MRI can clarify the position and dimensions of these tumors.
When a Person Should Avoid Neurosonography Assessment, Protocols, and Interpretation
Simply put, there are no specific reasons why a person can’t have a head ultrasound. This means it’s a procedure that can be done on anyone, without any particular restrictions or risks.
Equipment used for Neurosonography Assessment, Protocols, and Interpretation
An ultrasound machine is needed for this medical procedure. The device uses a part called a transducer, which is a tool that helps make the ultrasound image. We also use a special gel that helps the machine make a clear picture; this gel is placed on the skin, connecting it to the transducer so the ultrasound waves can pass through smoothly.
When it comes to the transducer, we use different types depending on the patient’s body and the part we want to see. Sometimes, we use ones that are 7.5 megahertz (MHz) or higher. These specific types are called linear array or sector transducers.
For new babies or larger babies, we may need to use a 5MHz transducer. When we need to check the surface areas like the brain or blood vessels on the surface, we use transducers with a higher frequency of about 10 MHz or more.
We also use two features called color and spectral Doppler to help us look at the blood vessels in more detail. This helps us see if there are any irregularities, like blocked vessels, unusual blood vessels in the brain, masses inside the head, or situations where there are more fluids than normal outside the brain.
Who is needed to perform Neurosonography Assessment, Protocols, and Interpretation?
A head ultrasound is usually carried out by a certified technician who is specially trained in children’s ultrasound imaging. In more challenging situations, a radiologist, a doctor who specializes in interpreting medical images, might directly handle the procedure. The ultrasound machine captures both still pictures and moving videos. These images are then transferred to a system, known as PACS, where the radiologist can analyze them.
Preparing for Neurosonography Assessment, Protocols, and Interpretation
There’s no need for patients to do anything special to prepare for this procedure.
How is Neurosonography Assessment, Protocols, and Interpretation performed
Images of a baby’s brain are taken using the large soft spot on the front of their head, also known as the anterior fontanelle. This soft spot naturally closes up over time, usually between 9 to 15 months of age, but it allows doctors to get clear images of the baby’s brain for at least the first 6 months of life. Images are taken from different angles and in different planes to get a complete picture of the brain.
Another soft spot, the mastoid fontanelle located near the baby’s ear, can provide images of the back part of the brain. This soft spot usually remains open until the child is 2 years old and is used to assess structures such as parts of the cerebellum, a region at the back of the brain, and the lateral ventricles, which are fluid-filled spaces in the brain.
Doctors then examine these images to get detailed views of different sections of the brain. In healthy newborn babies, for example, a certain type of brain tissue (white matter) appears slightly brighter on the images than another type (gray matter).
Sometimes, bleeding can occur in the brain, especially in babies born prematurely. This can be due to fragile blood vessels in an area of the brain called the germinal matrix. This bleeding or hemorrhage can be mild or severe, ranging from a small bleed confined to one area, to a large bleed that spreads into the cavities of the brain (ventricles) and the surrounding brain tissue.
Bleeding in the brain can cause the ventricles to expand due to the amount of blood, leading to a condition called hydrocephalus. This can sometimes lead to damage to the white matter of the brain, resulting in a condition known as porencephaly.
Finally, lack of oxygen to the brain (hypoxic-ischemic injury) can also cause brain damage, and this can be seen on the ultrasound images. The areas of the brain that are affected can depend on whether the baby was born prematurely or at term, and on how severe and long-lasting the lack of oxygen was.
Possible Complications of Neurosonography Assessment, Protocols, and Interpretation
Simply put, performing a head ultrasound doesn’t cause any problems or complications. This procedure is safe and trouble-free.
What Else Should I Know About Neurosonography Assessment, Protocols, and Interpretation?
Ultrasound is a harmless, non-radiating tool used to capture images of what’s going on inside your body. It’s a quick and convenient way to accomplish this, especially since it can be used at your bedside. This is particularly beneficial for critically ill newborn babies in the neonatal intensive care unit or those patients using a special life support system known as ECMO, who can’t be moved to a different department for other types of scans, like a CT or MRI.
Ultrasound is most often the first choice when newborn babies are showing signs like seizures and there’s a suspicion of a condition involving the brain. Although it’s worth mentioning that ultrasound might not be as sensitive as an MRI in picking up early signs of conditions caused by a shortage of oxygen and blood to the brain (hypoxic-ischemic brain injury, or HIE).
However, ultrasound has proven to be quite helpful in diagnosing severe cases of HIE and other brain conditions including internal bleeding in the skull, water on the brain (hydrocephalus), damage to the white matter near the ventricles in the brain (periventricular leucomalacia, or PVL), and more. It can also help decide whether more scans are needed and is commonly used to monitor any known brain condition.
Pediatric radiologists, who specialize in using medical imaging to diagnose conditions in children, should be acquainted with what is normal in the ultrasound images of both full-term and preterm infants’ brains. As well as with recognisable signs of various brain conditions that can appear in infants.
To sum up, ultrasound stands as a safe, reliable, efficiently portable, and widely accessible tool for quickly assessing the condition of a newborn baby’s brain right at their bedside when a brain condition is suspected.
