Ultrasound of the head

  • Patient preparation: none
  • Contrast used: none
  • Technique:
    — Review previous exams if available
    — Check transducer left / right orientation
    — Scan through the anterior fontanelle
    — Fill screen with image by varying the depth – use the 4th ventricle image for this
  • Images to obtain:
    — Coronal:
    — 1st – Through the orbits
    — 2nd – Star image (pentagon sign) through the Circle of Willis
    — 3rd – 3rd ventricle
    — 4th – 4th ventricle (check this image first to set depth)
    — 5th – Choroid plexus
    — 6th – Over the top of (posterior to) the lateral ventricles
    — Sagittal:
    — 1st – Midline
    — 2nd – Left of midline through lateral ventricle
    — 3rd – Even more left of midline through the Sylvian fissure
    — 4th – Midline
    — 5th – Right of midline through lateral ventricle
    — 6th – Even more right of midline through the Sylvian fissure
    — Take additional images of any pathology you see
  • Looking for:
    — In premature infant – germinal matrix hemorrhage, intraventricular hemorrhage, intraparenchymal hemorrhage, periventricular leukomalacia, edema, ventricular dilation
    — In term infant – hydrocephaleus or enlarged subarachnoid space
    — In pre-ECMO patient – intracranial developmental abnormality, pre-existing intracranial bleed
    — In ECMO patient – intraparenchymal hemorrhage, subdural hematoma, cerebral atrophy
  • Post procedure tasks: none