Neonatal Head and Spine Ultrasonography

175 Pages·2016·6 MB·English

by  Andrea Poretti

Andrea Poretti
Thierry A.G.M. Huisman
Editors
Neonatal Head and
Spine Ultrasonography
123
Neonatal Head and Spine
Ultrasonography

Andrea Poretti
Thierry A.G.M. Huisman
Editors
Neonatal Head and
Spine Ultrasonography
Editors
Andrea Poretti, MD Thierry A.G.M. Huisman, MD,
Assistant Professor of FICIS, EQNR
Radiology Professor of Radiology,
Head of Pediatric Pediatrics, Neurology
Neuroradiology and Neurosurgery
Research Division of Pediatric Chairman, Department
Radiology and Pediatric of Imaging and Imaging Science
Neuroradiology Johns Hopkins Bayview
Department of Radiology Medical Center
and Radiological Sciences Baltimore, MD, USA
T he Johns Hopkins Hospital
Baltimore , MD , USA Director, Division of Pediatric
Radiology and Pediatric
Neuroradiology
The Johns Hopkins Hospital
Baltimore , MD , USA
ISBN 978-3-319-14567-9 ISBN 978-3-319-14568-6 (eBook)
DOI 10.1007/978-3-319-14568-6
Library of Congress Control Number: 2015947271
Springer Cham Heidelberg New York Dordrecht London
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Pref ace
H ead and spine ultrasonography is an important tool in the
initial evaluation of intracranial and intraspinal abnormali-
ties in newborns. Ultrasonography is an incredibly versatile
bedside imaging tool in detecting brain and spine abnor-
malities in neonates, following the course of these lesions,
and evaluating the maturation of the neonatal brain and
spine. We believe it is a safe and cost-efficient alternative to
magnetic resonance imaging and computed tomography in
many cases.
This book allows readers to explore and advance their
knowledge with neonatal head and spine ultrasonography
and its application to a variety of common and rare neonatal
neurologic disorders. Organized to correspond to daily rou-
tine bedside practice, it presents a symptom-based approach
and classifies neonatal neurologic disorders at presentation.
For each symptom or finding, we present exemplary clinical
cases from our routine practice and illustrate how head and
spine ultrasonography may help in making the correct
diagnosis.
For the creation of the valuable collection of cases, we are
grateful to our coauthors, Drs. Frances J. Northington, Güneş
Orman, and Jacqueline Salas, who helped us with their inter-
est and expertise in this field to select the most interesting and
didactic cases and prepare succinct clinical vignettes as well as
illustrative, high-quality images. To be able to complete this
book, we were supported and intellectually challenged by a
v
vi Preface
number of brilliant physicians who are members of the
Neurosciences Intensive Care Nursery Program at the Johns
Hopkins Hospital, with their professional requests and stimu-
lating discussions at our weekly joint neonatal neurology
conference. This interdisciplinary culture has its roots in Johns
Hopkins’ four core values: excellence and discovery, leader-
ship and integrity, diversity and inclusion, and respect and
collegiality. These are as valid today as they were at the found-
ing of our hospital and our school of medicine in the late
nineteenth century.
We are thankful to Springer International Publishing AG,
who gave us the opportunity to publish our experiences with
neonatal head ultrasonography. We are particularly grateful
to Janet Foltin, Senior Editor, and Patrick Carr, Project
Coordinator, for their support in the conceptualization,
preparation, and realization of this book.
We hope that this book and case collection is as enjoyable
and helpful for readers as its preparation was for us.
Baltimore, MD, USA Andrea Poretti, MD
Thierry A. G. M. Huisman,
MD, FICIS, EQNR
Contents
1 Introduction.................................................................. 1
References ............................................................................. 3
2 How to Perform a Neonatal Head
Ultrasonography Study ............................................... 5
References ............................................................................. 18
3 Normal Head Ultrasound in the Preterm
and Term Newborn ...................................................... 19
References ............................................................................. 27
4 Seizures ......................................................................... 29
Differential Diagnosis of Brain Abnormalities
Associated with Neonatal Seizures That May Be
Detected by Neonatal Head Ultrasonography ............ 30
Arterial Ischemic Stroke (Figs. 4.1 and 4.2) .................. 31
Herpes Encephalitis (Figs. 4.3, 4.4, and 4.5) .................. 34
Congenital Cytomegalovirus Infection
(Figs. 4.6, 4.7, 4.8, and 4.9) ........................................... 38
Intraventricular Hemorrhage with Periventricular
Venous Infarction (Figs. 4.10 and 4.11) ..................... 43
Periventricular Subependymal Heterotopia
(Figs. 4.12 and 4.13) ..................................................... 46
References ............................................................................. 49
5 Encephalopathy ........................................................... 51
Differential Diagnosis of Brain Abnormalities
Associated with Neonatal Encephalopathy That May
Be Detected by Neonatal Head Ultrasonography ...... 52
Hypoxic-ischemic Injury (Figs. 5.1, 5.2, and 5.3) .......... 53
vii
viii Contents
Intraventricular Hemorrhage (Figs. 5.4 and 5.5) .......... 57
Subdural Hematoma (Figs. 5.6, 5.7, and 5.8) ................. 60
Bacterial Meningitis (Figs. 5.9 and 5.10) ....................... 64
Herpes Encephalitis (Figs. 5.11, 5.12, and 5.13) ............ 67
Maple Syrup Urine Disease (Figs. 5.14 and 5.15) ........ 71
References ............................................................................. 74
6 Muscular Hypotonia .................................................... 75
Differential Diagnosis of Brain Abnormalities
Associated with Muscular Hypotonia That May Be
Detected by Neonatal Head Ultrasonography ............ 76
Joubert Syndrome (Figs. 6.1, 6.2, and 6.3) ..................... 77
References ............................................................................. 81
7 Hemiparesis .................................................................. 83
Differential Diagnosis of Brain Abnormalities
Associated with Hemiparesis/Hemiplegia That May
Be Detected by Neonatal Head Ultrasonography ...... 84
Arterial Ischemic Stroke (Figs. 7.1 and 7.2) .................. 85
Intraventricular Hemorrhage (Figs. 7.3, 7.4,
and 7.5) .......................................................................... 88
Unilateral Periventricular Venous Infarction
(Fig. 7.6) ........................................................................ 92
References ............................................................................. 94
8 Apnea ............................................................................ 95
Differential Diagnosis of Brain Abnormalities
Associated with Apnea That May Be Detected
by Neonatal Head Ultrasonography .............................. 96
Cerebellar Hemorrhage (Figs. 8.1 and 8.2) ................... 97
Intraventricular Hemorrhage (Figs. 8.3 and 8.4) .......... 100
References ............................................................................. 103
9 Microcephaly ................................................................ 105
Differential Diagnosis of Brain Abnormalities
Associated with Microcephaly That May Be
Detected by Neonatal Head Ultrasonography ............ 106
Lissencephaly (Figs. 9.1, 9.2, and 9.3) ............................. 107
Schizencephaly (Figs. 9.4 and 9.5) .................................. 111
Congential Rubella Infection (Figs. 9.6, 9.7,
and 9.8) .......................................................................... 114
References ............................................................................. 118
Contents ix
10 Macrocephaly ............................................................... 119
Differential Diagnosis of Brain Abnormalities
Associated with Macrocephaly That May Be
Detected by Neonatal Head Ultrasonography ............ 120
Post-hemorrhagic Hydrocephalus
(Figs. 10.1, 10.2, and 10.3) ............................................ 121
Chiari 2 Malformation (Figs. 10.4, 10.5, and 10.6) ........ 125
Dandy–Walker Malformation (Figs. 10.7, 10.8,
and 10.9) ........................................................................ 129
Vein of Galen Malformation (Figs. 10.10, 10.11,
and 10.12) ...................................................................... 133
References ............................................................................. 137
11 Craniofacial Dysmorphic Features ............................ 139
Differential Diagnosis of Brain Malformation
Associated with Craniofacial Dysmorphic
Features That May Be Detected by Neonatal
Head Ultrasonography .................................................... 139
Holoprosencephaly (Figs. 11.1, 11.2, 11.3,
and 11.4) ........................................................................ 140
Agenesis of the Corpus Callosum
(Figs. 11.5 and 11.6) ..................................................... 145
References ............................................................................. 148
12 How to Perform a Neonatal Spine
Ultrasonography Study and Normal Spine
Ultrasound in the Neonate ......................................... 149
References ............................................................................. 155
13 Neonatal Spine Abnormalities ................................... 157
Types of Spinal Dysraphia That May Be Detected
by Neonatal Spine Ultrasonography ............................. 157
Myelomeningocele (Figs. 13.1 and 13.2) ........................ 158
Diastematomyelia (Fig. 13.3) .......................................... 161
Dorsal Dermal Sinus (Fig. 13.4) ..................................... 163
Caudal Regression Syndrome (Fig. 13.5) ...................... 165
References ............................................................................. 167
Index ...................................................................................... 169