home Audience 4 Neurosonography of the brain of newborns (ultrasound, NSG). The importance of neurosonography in the diagnosis of brain diseases in children What neurosonography shows in children

Neurosonography of the brain of newborns (ultrasound, NSG). The importance of neurosonography in the diagnosis of brain diseases in children What neurosonography shows in children

Neurosonography of the brain allows you to accurately, safely and painlessly identify pathologies in newborns at the first stage of development.

Neurosonography of the brain of newborns is a procedure associated with the examination of the brain. This examination replaced the MRI, which was carried out earlier.

This is due to a huge number of contraindications for MRI:

Having allergies.
Pituitary gland diseases.
Early pregnancy.
Presence of pacemakers and other implants.

That is why doctors tried not to prescribe MRI for babies and older children. Over time, an alternative to MRI was found: neurosonography.

Thanks to this procedure you can explore:

Spine.
Spinal cord.
Skull bones.
Scalp.

Thanks to neurosonography, it is possible to identify blood supply disorders, tumors or hernias, spinal injuries, as well as head injuries, and inflammation.

Neurosonography is of 3 types:

Why is ultrasound performed on newborns and infants?

As a rule, childbirth is a rather complex and traumatic process. It is not uncommon for a child to suffer a brain injury during childbirth. It is impossible to determine this injury without special equipment.

These injuries can subsequently seriously affect the mental and physiological development of the child. Early examination and identification of injury will help to begin treatment on time and avoid serious consequences.

Ultrasound can detect the following pathologies:

tumors;
hemorrhage;
inflammatory processes;
hydrocephalus.

How often can neurosonography be done on an infant?

Neurosonography of the brain of newborns is a safe procedure. The examination is carried out painlessly, within a few minutes. At the same time, it gives a complete picture of the baby’s brain structures.

As a result, the examination can be carried out without restrictions on the number of procedures. Whether the test should be used and how often it should be done is decided by either the attending physician or the pediatrician. In practice, to determine the health status of a child, once a week is enough.

What does neurosonography of a baby show?

Using neurosonography, you can get comprehensive information about the state of the child’s brain.

This examination can show:

Infant brain damage.
Presence of a cyst or tumor.
Clear reflection of convolutions.
Density of the ventricles of the brain and their size.
The content of fluid that is located between the cerebral hemispheres.
A general picture of brain development.

Indications for ultrasound for infants of different ages

Ultrasound is recommended for absolutely all children. Parents have the right to refuse an examination, but it is best not to do this, because it is impossible to confidently say without a full examination that the child does not have any pathologies and is completely healthy.

There are a number of “direct” indications for performing an ultrasound of a child’s brain.

Neurosonography is required if:

The child was born premature.
There is a possibility of chromosomal abnormalities.
Long lasting oxygen starvation child.
The birth occurred with complications (for example: incorrect position fetus, trauma during childbirth).
A score of 7 or less according to the Algar scale (the Algar scale is a rapid scoring system general condition baby).
The fontanel either sinks or, on the contrary, protrudes.

From birth to 2 months

For babies under 2 months of age, neurosonography is performed in the following cases:

In these cases, it is also possible to hospitalize the child and mother during the examination.

From 2 months to six months

There are cases when no pathologies were detected during neurosonography. And after 2-3 months the picture changes dramatically. This is due to the fact that not all pathologies manifest themselves in the first 2 months after the birth of a child.

For older children and up to six months, examination may be prescribed for the following reasons:

At the end of the examination, the doctor prescribes special measures to improve the child’s condition, and measures are also taken to bring the child’s brain function to the required state.

Are there any contraindications to the study?

There are no contraindications to the study as such. This is explained by the fact that there are no dangerous drugs not used during examination. The procedure is painless and without any harm to the child’s health.

With rare exceptions, doctors may refuse to perform neurosonography. For example, a child does not behave calmly during the procedure or a large area of the scalp or neck is damaged.

This procedure can be carried out repeatedly until the fontanel is completely overgrown.

Neurosonography is carried out until the child’s fontanelle closes. As a rule, this period is from birth to 12 months. Next, the procedure is carried out using the transcranial ultrasound method.

Brain defects in infants available with neurosonography

Neurosonography of the brain of newborns is a method through which it is possible to identify almost all pathological changes in the brain, in its vascular bed and in the ventricular system.

Most often, during examination, the following defects are found in infants:

In addition to neurosonography, may be prescribed additional examinations(for example, examination by a neurologist).

Preparing the baby for the procedure

There are no special measures when preparing a baby for neurosonography.

The most important thing is that the child eats and is not thirsty before the procedure - this will avoid whims during the examination.

If the child falls asleep, there is no need to wake him up. The baby will move less, and the procedure will go much faster.

For the procedure, you should take a diaper on which you can lay the baby. Do not apply ointments or creams before neurosonography. This will worsen the contact of the device’s sensor with the surface of the head, which will not allow obtaining the most accurate results.

Ultrasound process

Neurosonography of the brain of newborns is most often done through the baby’s fontanel. This area is located between the frontal and parietal bone. In addition to the anterior fontanel, ultrasound can be done through a special occipital foramen of the child’s head and small lateral temporal fontanelles.

The neurosonography device is no different from a conventional ultrasound machine. It includes:

Sensor. With its help, all manipulations during the examination are carried out. There are two types of sensors:

Sensor with purity up to 6 MHz. This type of sensor is used for children under 2 months of age.
Sensor with 2 MHz purity. This type of sensor is used for older children.

Before the procedure, the child is placed on the couch, having first laid a diaper on it. During the procedure, the mother has the right to be present and hold the child’s head if necessary. A special gel is applied to the sensor, after which the doctor moves it over the child’s head. At this time, the impulses that the device receives are displayed on the screen in the form of a moving picture.

During an ultrasound, the doctor turns his attention to the cerebral ventricles, the cavities of the transparent septum, and the cisterns. Inspecting the tank for a doctor is very great importance. This is due to the fact that her condition shows developmental disorders posterior fossa skulls

The study lasts no more than 10 minutes. At the end of the examination, the child’s head should be gently wiped with a cloth to remove any remaining cream. The results of neurosonography will be ready after a few minutes.

Explanation of research indicators, table of norms

Neurosonography of the brain has certain data that is deciphered based on specific indicators and parameters. Standard indicators, which should be obtained after examining healthy newborns and older children, are prescribed in a special table of norms.

It is this that the sonologist will focus on when preparing the results of the study.

Externally, this table looks like this:

The object in question.	Normal for a newborn.	The norm for a child aged 1 to 3 months.	Normal for a child aged 6 months.
Large tank	44,9 (+/-4,5)	No more than 6 mm.	82,1 (+/-12,7)
Lateral ventricles	Front: 1.5 mm (+/-0.5 mm). Occipital: maximum 1.5 cm.	Front: no more than 2 mm. Occipital: no more than 1.5 cm.	64,7 (+/-12,8)
3rd stomach	4.5 mm (+/-0.5 mm)	No more than 5 mm.	4,8 (+/-1,2)
Subarachnoid space	No more than 3 mm.	No more than 2 mm
Brain Cloak	29,4 (+/-5,7)	40,1 (+/-2,5)	46,2 (+/-6,4)

Small deviations from the indicators in this table should not frighten the child’s parents. Often, small deviations are due to device errors.

In addition to the above data, the doctor must indicate the symmetrical or asymmetrical shape of the brain tissue.

If there are no deviations from the norms, then, as a rule, the furrows and gyri will be shown very clearly on the screen of the device.

In cases where everything is fine with the ventricles of the brain and there are no abnormalities, the sonologist must make a note that the ventricles are homogeneous and do not have any inclusions. If in the results, when describing the ventricles, the term “flakes” is written, this means that an area of hemorrhage has been found.

At good condition, the gap between the hemispheres should not be filled with any liquid. And the blood vessels of the brain should have a homogeneous structure.

The shape of the tentorium of the cerebellum in the absence of any abnormalities can be of two types:

In addition, in conclusion, neurosonography is used next norm for a healthy child:

The size of the body of the cerebral ventricle should be from 2 mm to 4 mm.
The size of the gap between the cerebral hemispheres is 2 mm.

When drawing up a conclusion, the doctor pays attention to all aspects of the birth of the child’s mother, namely:

Baby's weight after birth.
Duration of labor.
What injuries were sustained during childbirth?
How was the birth, were there any complications?
Did the child have oxygen deprivation?

What to do if deviations are identified?

If any abnormalities were identified during the examination, you must immediately contact a neurologist. It will be very good if this doctor is the one who performs the procedure.

Neurosonography of the brain allows the neurologist to determine whether the child needs treatment right now or can be limited to observation. Situations arise when newborns are prescribed a repeat examination in order to eliminate all possible errors.

Article format: Mila Friedan

Video about neurosonography of the brain

About neurosonography of the brain in children:

Ultrasound diagnostics has a very important place in pediatric practice. This is due to absolute safety this method combined with its accessibility and information content. Basic technique ultrasound examination of the brain in children of any age (mainly in newborns and infants) is neurosonography (NSG), which is described in this article.

What is it: the essence of the study

Neurosonography is a diagnostic test performed using ultrasound waves and allows one to study certain parameters of the brain. The essence of the method is that an ultrasound sensor, which is both its source and recorder, is installed in the skull area and affects the brain. In this case, part of the waves is absorbed by tissues, and the other part is reflected. By registering them in the form of a graphic image, we can draw a conclusion about some features of the anatomical formations and structure of the brain structures of the subject.

Important to remember! Neurosonography (NSG) is a method, the full implementation of which is possible only until that period of the child’s life while the large fontanel remains open!

Indications and to whom it is prescribed

Neurosonography is advisable in cases where medical indications arise in the form of complaints or certain symptoms indicating brain damage. Due to its safety and high diagnostic value neurosonography (NSG) began to be widely used for screening studies of all newborns at risk for the development of central pathology nervous system(primarily the brain).

Neurosonography (NSG) is indicated in the following cases:

Changes in the shape of the head in an infant or newborn child;
Exceeding the volume and size of the head circumference compared to appropriate age indicators;
Disproportional development in the form of an increase in the head volume parameter while maintaining a normal chest circumference;
Birth of a child immature or with signs of hypoxia perinatal lesion(less than 7 points on the Apgar scale);
The presence of prematurity in the infant or signs of intrauterine development disorders (stigmas of disembryogenesis);
Newborns whose brain ultrasound (neurosonography or NSG) indicators were abnormal during pregnancy;
Genetic syndromes and any developmental defects in the child;
Convulsive syndrome;
Pregnancy against the background of severe toxicosis, difficult childbirth, especially long lasting in abnormal presentation of the fetus, with a long anhydrous period or entanglement of the umbilical cord;
All newborns from caesarean section who at the time of birth required and carried out resuscitation measures;
Regular regurgitation and frequent vomiting;
Constant or frequent restlessness of the child with pronounced crying for no apparent reason;
Children born during Rh-conflict pregnancy.

Up to what age is the procedure performed?

Bone tissue is a serious obstacle to ultrasound. In children after one year, just like in adults, the brain is closed in a dense, inextricable cranium. In newborns and children of the first year, there are small gaps between the bones like windows - fontanelles. With regard to neurosonography, you need to understand that this is an anatomical formation through which ultrasound waves freely pass through the brain tissue. Therefore, the most complete neurosonography (NSG) is done only in children before the closure of the large fontanelle, which is located on the parietal part of the head. The period of its closure is individual for each child and can range from 6 months to 1.5 years. For most children, this is 10-12 months of life.

Important to remember! Some of the brain parameters determined by classical neurosonography (NSG) can be studied even after the fontanelles are closed. In older children age groups The method is one of the important diagnostic tests that allows us to determine the nature of traumatic injuries brain with closed TBI and inability to use more modern techniques(CT or MRI)

What does NSG show (what can be seen on ultrasound)

NSG (neurosonography) allows you to visualize the following brain structures in a newborn:

The ventricles of the brain and indicators of the main structures through which the brain fluid (CSF) circulates;
The severity and nature of the convolutions of the brain, as well as the furrows between them;
Plexus of intracranial vessels and their characteristics (if the study is supplemented by transcranial Dopplerography);
Dense processes of the dura mater of the brain, dividing it into anatomical sections (falciform process and tentorium cerebellum);
The gap between the hemispheres of newborns;
The nature of the midline structures of the brain and the symmetry of the formations located on either side of them;
Characteristics of the space located under the arachnoid membrane of the brain (subarachnoid space);
Identification of additional formations in the cranial cavity that should not be normal (anomalies and malformations, cystic cavities, vascular growths and angiodysplasia, softening of certain areas of the brain (leukomalacia).

How to prepare for a brain ultrasound

NSG (neurosonography) does not require preparation. The procedure can be performed as follows: emergency indications, and as planned. The main condition for its usefulness is an open large fontanel in the child. The only point that to some extent determines the preparation is the choice of the specialist who will conduct neurosonography. In resolving this issue, it is better to listen to the advice of your doctor or rely on your own experience.

Interpretation of ultrasound readings

NSG (neurosonography) requires certain knowledge in terms of correctly assessing the results of the study.

A breakdown of the most common neurosonography conclusions is given in the table.

Identified changes and diseases in NSG	What it looks like or is described and what neurosonography says
Cystic formations of the choroid plexus (their cysts)	Additional formations in the form of small liquid structures in places where concentration is visualized large quantity vessels. They do not require any correction
Subepindymal cysts	Small cavities in the area of the ventricles of the brain containing fluid. They don't carry great danger, regardless of age
Arachnoid cysts	Additional cavity formations located in the area of the arachnoid membrane, filled with liquid. Require dynamic observation and systematic monitoring by a neurologist
Phenomena intracranial hypertension(hypertension syndrome)	It manifests itself as a slight increase in the size of the ventricles of newborns and their tension. In this case, the brain tissue is usually not changed if hypertension does not reach critical values. This child needs urgent treatment
Hydrocephalus with neurosonography (NSH)	Looks like a pronounced expansion of the ventricles with their tension and to varying degrees thinning of the cerebral cortex. Decoding - talks about what is happening destructive processes and progression of intracranial hypertension. The effectiveness of treatment can be judged by the degree of its severity.
Hemorrhages into the ventricular system or brain tissue	Possesses an immediate threat to the life of the child. Requires immediate specialized treatment
Displacement of the midline structures of the brain, determined by neurosonography, at any age of the child	It is a consequence of compression of the brain in one of the hemispheres. Median structures shift in the direction opposite to the volumetric process. Explanation - this may be due to tumor, traumatic (hematomas) or other intracranial additional formations
Focal changes in brain tissue. Identifies both the standard procedure and additional transcranial Dopplerography of blood vessels	May be represented by foci of ischemia (insufficient blood supply), softening (leukomalacia), air cavities (cysts), tumor tissue, vascular aneurysms

Important to remember! A full interpretation of any changes identified during neurosonography can be performed exclusively by a neurologist!

Norms of ultrasound readings

Neurosonography can detect not only visually detectable pathological changes in the child’s brain. Through a number of important measurements, the study reveals initial signs or prerequisites for the development of diseases. Norms this study represents the table.

Additional parameters that include NSG (neurosonography) represent the following normal indicators:

Homogeneity of brain structure;
Distinctness and sufficient depth of cerebral convolutions and sulci;
Normal, symmetrical structure of the cerebellum;
The position of the falciform process must be correct and even;
It is mandatory to assess the clear symmetry of paired or unpaired formations of the ventricular system of the brain both in relation to different hemispheres and in relation to the median structures;
Among the anatomical formations of the brain there should be no cystic, tumor, abnormal, vascular or any other additional inclusions.

Important to remember! The results of neurosonography are best assessed in conjunction with clinical and other data. additional methods research!

The brain is considered one of the most complex and mysterious human organs. The quality of life and developmental characteristics of the child depend on his condition and health. Therefore, behind the brain it is established special control, which begins from the very birth of the child. The neurosonography method helps to find out whether the baby’s brain is correctly formed and develops normally. We will talk about how the examination is carried out and what it shows in this article.

What it is?

Neurosonography is an ultrasound examination of the baby's brain. In fact, this is an ordinary ultrasound, well known to everyone, but it is only carried out at the most convenient period, when the baby’s “fontanelles” have not yet closed.

The mobility of the skull bones is necessary for the baby to ensure the passage of the head through the mother's birth canal during birth. And that's enough for a long time“fontanelles” remain uncovered. It is this feature that makes possible to carry out Ultrasound scans of brain structures looking for signs of congenital or acquired diseases.

Usually, NSG of the brain is performed in newborns and children under the age of one and a half years; after this age, the “fontanelles”, as a rule, close. After this, research through the temporal lobes is possible for some time, and then it will be possible to obtain information about the state of the brain only through electroencephalography (EEG), computed tomography(CT) or MRI.

Neurosonography has been included by the Russian Ministry of Health in the list of comprehensive ultrasound examinations for the first screening, which is performed on infants at 1 month. Earlier and later than this period, the examination is carried out if there is medical indications, which we will discuss below.

Is it safe?

Despite a lot of rumors, most which are generated by parents themselves on numerous forums on the Internet, the study is considered safe and harmless for babies. The essence of what is happening is quite simple, and deep knowledge of physics is not required to understand it: the sensor generates ultrasonic waves of a certain frequency and length, the waves pass perfectly through tissue human body, reflected from different structures brain in different ways and, reflected, go back on their way.

The sensor detects the “response” and forms an image on the monitor of the ultrasound machine. It is this image that the doctor evaluates, but again not “by eye,” but with the help of special mathematical algorithms included in software scanner.

Rumors about harm, it is possible, were not born out of nowhere, because medicine, which has been using the ultrasound method for only about 20 years, does not yet have a sufficient statistical base to prove the absence of harm from ultrasound exposure in the future. It takes significantly more than two decades to collect such information.

However, the data confirming harmful effects Ultrasound examinations on children's body, also no. Therefore, the procedure is considered safe. It doesn't hurt the baby. Opponents of the study should be reminded about ultrasound during pregnancy, because part of the fetal brain structures were assessed through the anterior abdominal wall

pregnant woman. But neurosonography of an infant allows us to get a more complete picture of the structures and functioning of his brain.

If necessary, the baby can undergo neurosonography as many times as needed to establish or clarify the diagnosis until the fontanelle heals and the bones of the skull begin to become strong.

Technique

Technically, neurosonography is not much different from any other ultrasound examination. The child is placed on a diaper laid on the couch in a supine position. The doctor applies a small amount of acoustic gel to the fontanel area for a tighter fit of the sensor and better conductivity of ultrasonic waves. Within 7-10 minutes, the sensor moves over the baby’s head, measurements are taken of individual parts of the brain, after which the parents are given an NSG protocol.

There is an NSG with advanced capabilities - with Doppler. This study provides insight not only into the structures, shapes and sizes of areas and parts of the brain, but also into the process of blood supply to this important organ.

The mother may well feed the child before the examination so that the baby does not worry and allows the doctor to examine himself. But even if your little one bursts into tears during the scan, this will not affect the results in any way: neither the size nor the functions of the brain regions change depending on the baby’s behavior.

Who needs it?

As already mentioned, it is advisable to do NSG for all babies at 1 month or at 3 months, if for some reason medical checkup was not performed on a child at four weeks of age.

The advice of the Ministry of Health is, of course, advisory in nature, and therefore parents can refuse the examination, but this is not recommended, because if there are pathologies later, when the “fontanel” begins to close, diagnosis will be difficult.

However, there are categories of children for whom neurosonography is especially recommended. First of all, these are children who were born prematurely (up to 37 weeks of pregnancy inclusive). Premature children are a special risk category, including the likelihood of developing pathologies in the brain and central nervous system. Experts also consider it mandatory conducting NSG children whose appearance occurred surgically- if the woman had a caesarean section.

If a child exhibits the following symptoms during the first weeks of life, parents should also not refuse to undergo neurosonography:

the child behaves strangely - in the absence of illnesses, he eats poorly, regurgitates frequently and profusely, he is inactive, does not show strong emotions, often cries, sleeps superficially, constantly wakes up, if the baby has pronounced tremor of the limbs, chin, or has strabismus;
the baby often cries, throws back his head and arches his back (this may be indirect sign increased);
the baby hears poorly or reacts poorly to visual stimuli, does not follow the toy with his eyes, and cannot focus his gaze on the mother’s face;
low blood arterial pressure baby, fainting, convulsions;
severe coordination disorders (infant flapping and shuddering have nothing to do with it);
the child has birth injury or he fell, hit his head, or there was a sharp throwing back of the head after birth.

If a child is scheduled for vascular or heart surgery in the near future, NSG is mandatory. An unscheduled neurosonographic examination will be carried out in the event of a fall, because the method allows one to establish signs of a concussion, bruise, or the formation of cerebral hematomas.

A child who had a hard time viral infection, should also be examined to rule out signs of encephalitis or meningitis. The NSG method is also used in the diagnosis of tumors.

It is imperative to examine children who were born with a low weight (less than 2700 grams), as well as children who were born with asymmetry (who have one ear lower than the other, one eye larger than the other, etc.)

External anatomical malformations (presence of extra fingers and toes, absence of limbs, etc.) are also a good reason for a careful ultrasound examination of the infant’s brain.

Children born after pregnancy, which was accompanied by fetal hypoxia and Rh conflict, must undergo NSG, since the long-term consequences of these unfavorable intrauterine conditions can be quite severe.

Normal indicators

U healthy child up to a year, and in children older, both hemispheres are symmetrical. It is this indicator that the doctor evaluates and describes first. Violation of symmetry can be a sign of how congenital anomalies, and the development of the tumor process.

In a healthy child, the grooves and convolutions of the cerebral cortex are well visualized; all structural units, without exception, are distinguished by clear and even contours. No fluid is found in the spaces between the right and left hemispheres of a healthy toddler.

The ventricles and cistern have certain dimensions that correspond to the tables by which the indicators are deciphered. The radiant fascicles show signs of hyperechogenicity.

Ventricles of the brain, as indicated in the study protocol healthy baby, have a homogeneous structure, without foreign inclusions. If mom and dad are very interested in the meaning of the numbers in the conclusion, then normal indicators are:

lateral ventricles - anterior horns - 2 mm (after 3 months - 2-4 mm);
lateral ventricles-posterior (occipital) horns - 10-15 mm;
body of the lateral ventricles - no more than 4 mm;
the size of the third ventricle of the brain is 3-5 mm;
fourth ventricle - no more than 4 mm;
interhemispheric fissure - 3-4 mm;
cistern magna - maximum 10 mm;
subarachnoid space - on average 3 mm.

This data is not the ultimate truth. When making a medical conclusion, the doctor must take into account the height and weight of the child, because in a low-weight child with miniature shapes, the size of the brain regions may differ to a smaller extent.

Pathologies

By refusing the examination, parents risk not seeing it on time, and, therefore, not starting timely treatment in case of the presence of neoplasms of the cyst type. Cysts can be different - some, for example, arachnoid ones, are quite dangerous for the baby and definitely need treatment.

Neurosonography of the brain of newborns is an ultrasound examination. The procedure is safe and painless, can be performed from the moment of birth and does not require special preparation. The high information content of the study makes it possible to determine the presence of neurological abnormalities in the newborn and promptly take action. necessary measures to eliminate them.

Indications for examination of a newborn

NSG is carried out according to indications; a neonatologist or neurologist can prescribe the study.

The main reasons for prescribing an ultrasound of the brain in an infant:

intrauterine fetal hypoxia;
asphyxia (stopping breathing) of a newborn;
complication labor activity, rapid or protracted labor, application physical impact for the purpose of childbirth;
intrauterine infection (from the mother) of the fetus;
injuries received during childbirth;
transfer infectious diseases mother during pregnancy;
Rh conflict between mother and fetus;
delivery by caesarean section;
birth of a child ahead of schedule or with a lack of weight and development;
when diagnosing fetal pathology during pregnancy using ultrasound;
low baby’s Apgar score (less than 7 points);
when the child’s fontanel is tense or collapses;
if you suspect the development of cerebral palsy;
convulsive syndrome;
frequent regurgitation, especially after a significant period of time from feeding;
if there are signs of chromosomal diseases detected during pregnancy or after birth.

The procedure does not require special preparation and can be performed on the baby even in the intensive care unit. Neurosonography is absolutely harmless for a newborn and can be performed on a child even in the most in serious condition without the risk of making the situation worse.

The only necessary condition for the use of ultrasound of the brain in newborns is an open large fontanelle; from the moment it is closed, the procedure is impossible.

If it is necessary to study the baby’s brain when the fontanelle is closed, an MRI is performed.

Indications for examination of children 1, 3 and 6 months of age IN monthly period

All newborns are subject to ultrasound examination; in 3 and 6, the examination is carried out when a violation is detected.

Even if no abnormalities were detected by neurosonography of the brain at 1 month, a repeat study is prescribed if the following symptoms appear: backlog from age standards
development;
convulsions;
hypotonia (muscle weakness) in the arms or legs;
disturbance in the shape of the baby’s head structure;
increase in head size above normal;
hyperactivity; Cerebral palsy or symptoms of increased;
intracranial pressure
neurotoxic infections (meningitis or encephalitis);
strabismus;
signs of rickets;

symptoms indicating epileptiform activity.

In addition to the listed reasons for prescribing, NSG of the infant’s brain is performed to screen the development of premature infants.

Progress of the study

The only thing that is required from the mother is to calm the baby and hold his head during the examination.

Neurosonography of an infant takes about 10 minutes and gives a complete picture of the condition and structures of the brain.

Progress of the procedure:
the baby lies with his back on the couch;
the researcher applies a contact gel to the area of the large fontanel (improves the quality of the procedure, eliminates interference);
the sensor is installed;
a scan of brain structures is carried out with visualization on the device screen;

the necessary measurements are taken and the state of health is assessed.

Newborns practically do not pay attention to the procedure; it is recommended to feed the baby, so he will lie calmer.

After discharge from the maternity hospital, ultrasound scans of the brain are also possible in infants upon reaching 1, 3 and 6 months of age.

Interpretation of neurosonography

After the examination procedure, the doctor immediately hands over the results. The decoding of the values should be carried out by a neurologist, but the obtained values can not only be studied, but also compared with normal values

according to the baby's age.

Normal neurosonography values can be seen in the table.

Table of neurosonography indicators

In addition to the size of brain structures, neurosonography in children shows the following indicators:
symmetry of brain structures;
description of fissures and convolutions (visualized or not);
falx cerebral condition;
echogenicity and structure of the ventricles;
description of the interhemispheric fissure (whether there is fluid or not), according to ultrasound of the brain in newborns there should be no fluid;
state of the vascular network;
the presence of pathological structures (cyst, developmental disorder, fluid, blood accumulation (hematoma), etc.).

In NSG ultrasound in newborns, the decoding describes the structures of the brain. If no pathologies are identified, this will be written about in the conclusion. Neurosonography of newborns should not normally detect asymmetries in the structure, pathological changes in the vascular network, foci of impaired blood circulation (cerebral ischemia) and other abnormalities.

When performing neurosonography on a 3-month-old child, the doctor pays Special attention those indicators that should change by a given age.

Possible pathologies

The most common pathologies of young children:

Hydrocephalus. On ultrasound it is detected by recording the expansion of the lateral ventricles of the brain in newborns. This pathological process, characterized by the accumulation of cerebrospinal fluid in the cavity of the ventricle, which leads to stretching of their walls. The process requires emergency treatment under NSG control.
Hypertension (increased intracranial pressure). In the transcript of an ultrasound of the head in newborns, the diagnosis will be stated in the conclusion: “hypertensive-hydrocephalic syndrome.” Anxious state requiring treatment. The cause may be the formation of a cyst, hematoma, or accumulation of cerebrospinal fluid.
Cerebral ischemia is most often diagnosed by ultrasound of the brain in newborns. Normally, such a syndrome should not exist, regardless of the degree of term of the baby. The disease occurs as a result of persistent hypoxia, which causes the death of brain cells left without nutrition.
Hematoma is manifested by asymmetry of the lateral ventricles in infants; when diagnosing premature babies, the doctor takes an observational position; if detected in full-term babies, treatment is required.
Meningitis. It is expressed in thickening and deformation of brain tissue caused by inflammation. Requires medical intervention.
Various cysts are recorded on a neurosonogram of the brain; they represent a cavity filled with fluid. The tactics for managing a baby are different, depending on the etiology of the cyst and its size. Some require surgical intervention, others resolve on their own and are normally no longer detectable during NSG at 6 months.

An arachnoid cyst is found in the arachnoid membrane, a condition accompanied by the formation of a cavity with fluid, which is prone to growth, requires treatment, and cannot be cured on its own.
Choroid plexus cysts are prone to self-resorption. No correction required.

Tactics for detecting pathology

Neurosonogram of newborns is informative method identifying neurological abnormalities. After the manipulation, the child’s parents must bring the results of the NSG examination to the neurologist, according to which the doctor determines further treatment. In some cases, a wait-and-see approach is taken, in others, the required amount of intervention is applied.

Neurosonography () is diagnostic procedure, which consists of examining the brain of a newborn baby using an ultrasound machine.

This study is carried out either for prevention or on the recommendation of a neonatologist after initial examination of a child, which is carried out in the first three weeks of his life.

The ultrasound machine's sensor sends high-frequency waves into the brain, examining its structure and convolutions. The structure of the brain is reflected from these waves. As a result, a picture appears on the monitor. The examination is absolutely safe, does not cause discomfort or pain, and does not require special preparation or anesthesia.

Up to what age is the study done?

Neurosonography of newborns is carried out from birth to twelve months, if doctors suspect pathology in the development of the baby’s brain.

Ultrasound makes it possible to assess the condition of the brain and its structures, which helps make a diagnosis.

If the fontanel is already overgrown, then specialists perform a transcranial ultrasound examination, it is somewhat more expensive.

What anomalies can the procedure detect?

The study will help to “see” such pathologies:

Indications for the study

As mentioned above, the indication for neurosonography is the doctor’s suspicion of pathology in the development of the brain. The reasons for such conclusions may be:

Suitable for everyone

The undoubted advantage of this procedure is that it can be performed on all children and does not cause any harm. There's only one thing necessary condition for an effective procedure - this is not an overgrown fontanel

The advantage of neurosonography over other brain studies is obvious. After all, for example, to conduct - I - examinations, complete immobility is required, which is almost impossible to achieve from small child, any of his movements washes away the picture, so specialists have to resort to anesthesia.

When performing an ultrasound, anesthesia is not needed, the child is not exposed to any radiation, and the procedure can be repeated as many times as needed to make an accurate diagnosis or confirm that the pathology has disappeared.

How to prepare for diagnosis

Special rules for preparing for this species no ultrasound examination. The most important thing is that the baby does not be capricious, does not turn his head, does not cry, so, of course, it will be more difficult for a specialist. Every mother knows what she needs to make her child happy.

Before the procedure, it is better to feed the baby and put on a clean diaper.

You can take toys, a pacifier, and a bottle with you to calm your little patient in case he becomes capricious.

Progress of the procedure

The procedure is not complicated special difficulties will not cause. The mother spreads a diaper on the couch, puts the baby on his back, her task is to entertain the baby.

The doctor brings the sensor to the open fontanelles and begins the study from this part. This is why an open fontanel is so important. The fact is that dense, thickened bones cranium do not allow ultrasonic waves to “penetrate” inside.

Then the specialist inspects other areas that “pass” the ultrasonic pulses. He moves the sensor to fine temporal bone, and then examines the anterolateral fontanel, which is located on the line leading from the ear to the temple in front; Next comes the inspection of the posterolateral fontanel, this is the line from the ear to the temple at the back and the foramen magnum, it is located directly under the back of the head.

All these zones make it possible to study the posterior inferior, as well as the central areas of the brain, which are located at some distance from the large fontanel.

What are the features

If during the research some kind of disturbance in the functioning and development of the brain was identified, then there is no need to panic immediately. Results and the conclusion needs to be shown to the neurologist who is “caring” for the child, he will prescribe appropriate treatment, which may not be at all aggressive.

If you have pathologies, you should definitely ask your doctor about the advisability of vaccination.

For some diseases or neurological disorders, vaccinations are not recommended, as they can only worsen the situation and may require medical withdrawal for a certain period of time.

About the results, their interpretation and standards

In conclusion, the specialist indicates the symmetry of the structure of the brain, its echo structure, and the sensitivity of the pattern of convolutions and sulci. The examination protocol outlines the condition of the subcortical zones, periventricular zones, the condition and size of the ventricles, choroid plexuses, and stem cerebellar structures.

Only a doctor can make a correct description and decipher the examination results. All indicators are interrelated, and in one case, a slight deviation from the norm will not be critical due to the interrelation of certain indicators, but in another it can be an alarm bell.

It would be more advisable to obtain reliable information and comprehensive answers to questions about the baby’s condition from a neurologist. The ultrasound diagnostics doctor interprets the results of the study.

The table shows developmental norms, depending on age, which neurosonography will help identify