Introduction

The anterior fontanelle provides a convenient acoustic window through which to image the neonatal brain. An infinite number of different images can be produced, but several views have become standard because they allow visualization of important structures such as the germinal matrix. The standard coronal sections are shown in Fig. 4.1 and the sagittal sections in Fig. 4.2. The pictures and diagrams in this chapter are designed to help the novice ultrasonographer find his or her way around the intracranial anatomical landmarks of these standard views. Once these have been learnt there is then no substitute for time spent trying to identify the same structures in many different subjects. Reviewing scans with others, and relating ultrasound imaging appearances to the anatomy, which is illustrated with MRI, are an invaluable part of the learning process. We have included a description of three axial sections because these are such a standard aspect of MRI although of course axial sections are difficult to produce with ultrasound (Fig. 4.3).

We have relied on several sources, including our neuroradiology colleagues, for neuroanatomical information, but we find the atlases by Bayer and Altman to be a particularly useful resource [1].

Performing a cranial ultrasound examination

Begin by placing the transducer on the fontanelle with the plane of the ultrasound passing from ear to ear to produce a coronal section.