The central nervous system

doi:10.1017/CBO9780511978074.011

6 - The central nervous system

Published online by Cambridge University Press: 05 March 2012

Claire Miller and

Edited by

Monica Epelman and

Hiten Mehta: Affiliation:
University Hospitals Coventry and Warwickshire NHS Trust
Monica Epelman: Affiliation:
University of Pennsylvania
Claire Miller: Affiliation:
Birmingham Children's Hospital NHS Foundation Trust
Elaine M. Boyle: Affiliation:
University of Leicester Department of Health Sciences
Haresh Kirpalani: Affiliation:
Children's Hospital of Philadelphia
Monica Epelman: Affiliation:
Children's Hospital of Philadelphia
John Richard Mernagh: Affiliation:
McMaster University, Ontario

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Summary

Introduction

Neonatal imaging of the central nervous system has progressed rapidly in the last few years, although ultrasound (US) imaging remains the mainstay of bedside investigation. However, with the increased availability of magnetic resonance imaging (MRI), its potential utility is increasing. We highlight the relative usefulness of the imaging techniques available.

Principles of neuroimaging

Neuroinjury in the newborn

• In the preterm a range of potential effects stem from the physiologically large and vascular structure of the germinal matrix of the preterm; and may include the superadded effects of hypoxemia or ischemia. These extend from bleeds, to obstructive lesions of the ventricles, to periventricular leukomalacia. Details of the neuroanatomical effects that are usually seen clinically are discussed below under “A standard approach to assessing normal anatomy on US examinations.” Figure 6.1A–D shows diagrams that depict the anatomical location of the germinal matrix and its potential for damaging changes. These are coupled with corresponding ultrasound images and can be compared with those in Figure 6.2. Figure 6.3A–D shows the relevant comparable MRI images. Figure 6.4A–C shows relevant US anatomy in axial scans obtained via a transmastoid approach. Finally, Figure 6.5A–D shows US Doppler images obtained for the evaluation of the superior sagittal sinus with a corresponding MR venography image.

Type: Chapter
Information: Imaging of the Newborn , pp. 106 - 138

DOI: https://doi.org/10.1017/CBO9780511978074.011 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2011

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