Neurosonography of the chest. Neurosonography. How is an ultrasound scan of the brain of a newborn

Neurosonography (NSG) is a term applied to the study of the brain of a young child: a newborn and an infant until the fontanel is closed by ultrasound.

Neurosonography, or ultrasound of the child's brain, can be prescribed by the pediatrician of the maternity hospital, the neurologist of the children's clinic in the 1st month of life as part of the screening. In the future, according to indications, it is carried out on the 3rd month, on the 6th month and until the fontanel closes.

As a procedure, neurosonography (ultrasound) is one of the safest research methods, but it should be carried out strictly according to the doctor's prescription, because. ultrasonic waves can have a thermal effect on body tissues.

At the moment, no negative consequences in children from the neurosonography procedure have been identified. The examination itself does not take much time and lasts up to 10 minutes, while it is completely painless. Timely neurosonography can save the health, and sometimes the very life of the child.

Indications for neurosonography

The reasons for requiring an ultrasound scan in the maternity hospital are varied. The main ones are:

• fetal hypoxia;
• asphyxia of newborns;
• difficult childbirth (accelerated / prolonged, with the use of obstetric aids);
• intrauterine infection of the fetus;
• birth trauma of newborns;
• infectious diseases of the mother during the gestation period;
• Rhesus conflict;
• C-section;
• examination of premature newborns;
• ultrasound detection of fetal pathology during pregnancy;
• less than 7 points on the Apgar scale in the delivery room;
• retraction / protrusion of the fontanel in newborns;
• suspected chromosomal pathology (according to a screening study during pregnancy).

Indications for ultrasound examination within a month:

• suspected ICP;
• congenital Apert syndrome;
• with epileptiform activity (NSG is an additional method for diagnosing the head);
• signs of strabismus and the diagnosis of cerebral palsy;
• the girth of the head does not correspond to the norm (symptoms of hydrocephalus / dropsy of the brain);
• hyperactivity syndrome;
• injuries in the head of the child;
• lag in the development of the infant's psychomotor;
• sepsis;
• cerebral ischemia;
• infectious diseases (meningitis, encephalitis, etc.);
• rickety shape of the body and head;
• CNS disorders due to a viral infection;
• suspicion of neoplasms (cyst, tumor);
• genetic anomalies of development;
• monitoring the condition of premature babies, etc.

Preparation and method of conducting the study

Neurosonography does not require any preliminary preparation. The baby should not be hungry, thirsty. If the baby fell asleep, it is not necessary to wake him up, this is even welcome: it is easier to ensure the immobility of the head. The results of neurosonography are issued 1-2 minutes after the completion of the ultrasound.

You can take milk for the baby, a diaper with you to put the newborn baby on the couch. Before the NSG procedure, it is not necessary to apply creams or ointments to the fontanel area, even if there are indications for this. This worsens the contact of the sensor with the skin, and also negatively affects the visualization of the organ under study.

The procedure is no different from any ultrasound. A newborn or infant is placed on a couch, the place where the skin contacts the sensor is lubricated with a special gel substance, after which the doctor performs neurosonorography.

Access to the structures of the brain during ultrasound is possible through the large fontanel, the thin bone of the temple, the anterior and posterolateral fontanelles, as well as the large occipital foramen. In a child born at term, small lateral fontanelles are closed, but the bone is thin and permeable to ultrasound. The interpretation of neurosonography data is carried out by a qualified doctor.

Normal NSG results and interpretation

Deciphering the diagnostic results consists in describing certain structures, their symmetry and tissue echogenicity. Normally, in a child of any age, the structures of the brain should be symmetrical, homogeneous, corresponding to echogenicity. In deciphering neurosonography, the doctor describes:

• symmetry of brain structures - symmetrical / asymmetric;
• visualization of furrows and convolutions (should be clearly visualized);
• condition, shape and location of the cerebellar structures (natata);
• state of the cerebral crescent (thin hyperechoic strip);
• the presence / absence of fluid in the interhemispheric fissure (there should be no fluid);
• homogeneity/heterogeneity and symmetry/asymmetry of the ventricles;
• the state of the cerebellar plaque (tent);
• absence / presence of formations (cyst, tumor, developmental anomaly, change in the structure of the medulla, hematoma, fluid, etc.);
• the state of the vascular bundles (normally they are hyperechoic).

Table with standards for neurosonography indicators from 0 to 3 months:

Structures should not contain inclusions (cyst, tumor, fluid), ischemic foci, hematomas, developmental anomalies, etc. The decoding also contains the dimensions of the described brain structures. At the age of 3 months, the doctor pays more attention to the description of those indicators that should normally change.

Pathologies detected by neurosonography

According to the results of neurosonography, a specialist can identify possible developmental disorders of the baby, as well as pathological processes: neoplasms, hematomas, cysts:

1. Choroid plexus cyst (do not require intervention, asymptomatic), usually there are several. These are small bubble formations in which there is a liquid - cerebrospinal fluid. Self-absorbing.
2. Subependymal cysts. Formations containing liquid. Occur due to hemorrhage, can be pre- and postpartum. Such cysts require observation and possibly treatment, as they may increase in size (due to the failure to eliminate the causes that caused them, which may be hemorrhage or ischemia).
3. Arachnoid cyst (arachnoid membrane). They require treatment, observation by a neurologist and control. They can be located anywhere in the arachnoid membrane, they can grow, they are cavities containing liquid. Self-absorption does not occur.
4. Hydrocephalus / dropsy of the brain - a lesion, as a result of which there is an expansion of the ventricles of the brain, as a result of which fluid accumulates in them. This condition requires treatment, observation, control of NSG over the course of the disease.
5. Ischemic lesions also require mandatory therapy and control studies in dynamics with the help of NSG.
6. Hematomas of brain tissue, hemorrhages in the space of the ventricles. Diagnosed in premature babies. In full-term - this is an alarming symptom, require mandatory treatment, control and observation.
7. Hypertension syndrome is, in fact, an increase in intracranial pressure. It is a very alarming sign of a significant shift in the position of any hemisphere, both in premature and in term babies. This occurs under the influence of foreign formations - cysts, tumors, hematomas. However, in most cases, this syndrome is associated with an excess amount of accumulated fluid (liquor) in the space of the brain.

If any pathology is detected during ultrasound, it is worth contacting special centers. This will help to get qualified advice, make a correct diagnosis and prescribe the correct treatment regimen for the child.

Neurosonography (NSG) has become a real revolution in the study of brain pathologies in newborns. The method is informative and safe - just what is so necessary for the diagnosis of children in the first years of life. This special ultrasound helps to assess the size and structure of the components of the brain, to see in time the presence of pathological changes, whether congenital or resulting from birth trauma.

The term is formed from three foreign words: the Latin sonus (sound), as well as the Greek neuron (nerve) and grapho (I write). The root of the word indicates the principle of the method: ultrasound penetrates into soft tissues, but is reflected from seals and inhomogeneous parts. Therefore, the examination is ideal for babies in the first year of life, because only they have “windows” in their skull for the procedure - fontanelles.

Neurosonography of newborns is done through cartilaginous areas that have not had time to ossify, called fontanelles, of which there are four in a little man. The brain is examined through the largest of them - the anterior, located at the junction of the frontal and parietal bones. It fits the best, as it closes closer to a year and a half and is quite wide.

Direct indications for ultrasound of the brain in a newborn

It is planned to undergo such an examination, preferably for every baby at the age of 1-2 months. It is as important as ultrasound of the hips and heart and is often included in the screening program for newborns.

Ungrown fontanelles make it possible to carry out the procedure for children up to 1.5-2 years old

However, there are specific indications in which neurosonography is mandatory. Among them are the following:

• prematurity;
• labor activity was accompanied by problems: rapid or prolonged labor, improper presentation of the fetus, the use of obstetric aids, injuries during childbirth;
• fetal hypoxia (prolonged oxygen starvation), asphyxia during childbirth;
• during the prenatal period, infections were transferred or fetal pathology was detected;
• childbirth by caesarean section;
• an Apgar score of 7 or less;
• Rh incompatibility of the newborn with the mother;
• the fontanel sinks or protrudes;
• there are concerns about the presence of chromosomal abnormalities.

Indications for ultrasound of the brain in infants at 1, 3 or 6 months

It happens that the ultrasound picture at the age of 1 month is within the normal range, and after 2-3 months the indicators become worse, since not all brain pathologies appear immediately.

In such cases, indications for an additional ultrasound examination will be as follows:

• symptoms of neurological diseases: delayed psychomotor development, convulsive manifestations, muscle weakness (hypotension) of the upper or lower extremities;
• unusual or special structure of the facial skeleton;
• rapidly increasing head size;
• suspicion of intracranial pressure, cerebral palsy or hyperactive syndrome;
• Apert syndrome (abnormal development of the cranium);
• transferred infectious diseases: meningitis, encephalitis;
• suspicion of strabismus, rickets;
• signs of epileptiform activity;
• developmental control of premature babies.

Is it safe to do neurosonography?

Yes. An ultrasound of the brain is a safe procedure. There are no contraindications for it, and no side effects have been described. Ultrasound diagnostic devices are subject to strict controls regarding safety issues.

How to prepare for research?

No special preparatory measures are required. Just try to feed and drink the baby before the study so that he does not have a reason to be capricious. And if the baby fell asleep, this is not a problem. Neurosonography of newborns is done even in intensive care, the baby is not taken out of the ditch.

Neurosonography can be performed in almost any conditions

Take a diaper with you, you will need to lay it on the couch and lay the baby. Before an ultrasound, you can not use creams and ointments in the head area, even if they are used for medicinal purposes. Such “layering” will negatively affect the visualization of brain structures due to poor contact between the sensor and the skin.

Carrying out neurosonography

The procedure itself is not much different from a conventional ultrasound. The child is placed on the couch, a special gel is applied to the study site, which ensures proper glide of the sensor.

The doctor with careful movements, without pressure, drives the sensor over the head. An ultrasonic pulse is sent to the receiving apparatus, where it is converted into an electrical one. The image is then displayed on the monitor.

Almost always, neurosonography is performed through the anterior fontanel, but in the first month it is possible to study it through the occipital (at the base of the neck) and lateral fontanelles (in the temples).

What pathologies can be detected during the study?

Hydrocephalus. A condition when CSF (cerebrospinal fluid) accumulates in the ventricles of the brain, the ventricles themselves stretch (expand). It is characterized by a rapid increase in head circumference. The disease requires treatment with regular monitoring of NSG dynamics.

hypertensive syndrome. Pathology in which intracranial pressure increases. Usually the reason for this is birth trauma, tumors, cystic formations, hematomas - that is, everything that occupies a certain volume of the brain. But most often the reason is the excessive accumulation of cerebrospinal fluid in the ventricles, and therefore the diagnosis basically sounds like a hypertensive-hydrocephalic syndrome.

cerebral ischemia. Occurs with persistent hypoxia, when parts of the brain die due to a lack of oxygen. Typical for premature babies.

Choroid plexus cyst. Small neoplasms in the form of vesicles filled with cerebrospinal fluid. They require only observation, since they tend to resolve on their own.

Education is located in the space of the arachnoid membrane. Unlike a choroid plexus cyst, it does not resolve itself, therefore it requires treatment.

Arachnoid cyst needs to be treated

The cyst is subependymal. It is also a cavity filled with liquid. Occurs due to hemorrhage. Such formations are observed, since both self-elimination and further growth are possible. The main thing is to remove the reason why the cyst arose, that is, to treat ischemic lesions in the first place and prevent subsequent hemorrhages.

Meningitis. Inflammation of the meninges due to infection. With it, the brain tissue thickens and deforms.

Intracranial hematomas. These are hemorrhages in the cavity of the ventricles. In premature babies with an immature brain, they are common. However, when they are diagnosed in full-term babies, treatment is mandatory.

How to understand what the result of the survey is: transcript

After the examination, you will be given an A4 sheet with the results and indicators. It is important to remember that decoding plays a key role here and should only be carried out by an experienced, qualified neurologist.

The examination sheet describes the data obtained with the help of ultrasound. Normally they will look something like this:

• brain structures are symmetrical;
• the cerebral crescent looks like a thin echogenic strip;
• furrows and convolutions are clearly visualized;
• the ventricles are symmetrical, homogeneous;
• there is no fluid in the interhemispheric fissure;
• neoplasms are absent;
• vascular bundles are hyperechoic.

The research norms are described in numbers in the table. But parents don't have to memorize them. If everything is in order, the conclusion will necessarily contain the inscription “no pathologies detected”.

If defects were found, they will also be described as a diagnosis. The decoding of possible pathologies is presented in the paragraph above.

What to do if deviations are found?

First of all, with the results of the examination, they go to a neurologist. He determines the nature of the pathology, the degree of its severity and decides whether treatment is necessary at this stage or whether it is enough to observe for now.

Sometimes it is advisable to do a second study, since it is not always possible to objectively evaluate the studied parameters. For example, a doctor may take for pathology any area where the echogenicity is changed. In addition, the condition of the baby (for example, if he screamed) affects the accuracy of the results.

So, neurosonography is a modern method of ultrasound examination and meets all safety requirements. It is a godsend for doctors, because it allows you to see those changes that they previously only assumed. Successful treatment begins with an accurate diagnosis. Therefore, if you are offered to undergo such an examination, do not refuse.

Ultrasound examination allows you to study the work and structure of internal organs. With the help of wave reflection, the finished data is sent to the monitor. Ultrasound of the brain in infants is a mandatory procedure for a preventive examination. Thanks to the data obtained, it is possible to judge the structure of the brain and the functioning of the vascular system. The study is carried out quickly and painlessly, it does not pose any danger to the child.

NSG (neurosonography) allows you to determine violations in the functioning and structure of all brain structures, as well as evaluate the work of the central nervous system.

NSG is carried out through the fontanel, which is located between the unfused bones of the skull. Thanks to this, the result will be accurate and correct. The fontanel is soft to the touch, a pulsation is felt. Normally, it should be at the level of the surface of the head. Swelling indicates health problems.

The NSG procedure does not require additional preparation - it is enough to free the child's head from the cap. The result is not affected in any way by the condition of the child, even if he cries, is naughty or calmly studies the situation. The procedure is carried out even when the child is sleeping.

What is the reason for this study

Ultrasound is a mandatory planned procedure in one month. In other cases, indications for NSG before the first month of life are the following cases:

In one month, mandatory NSG is carried out in the following cases:

• children who were born by caesarean section;
• irregular head shape;
• conduct a study to monitor the condition;
• with such developmental disorders as torticollis, strabismus, paralysis;

For children older than one month, NSG is done according to the following indications:

• evaluate the effectiveness of treatment for injuries or neurological diseases of the brain;
• after infectious diseases (encephalitis, meningitis);
• genetic and gene disorders;
• head injury.

In some cases, an MRI of the brain is indicated, which is performed under anesthesia.

Interpretation of the results obtained during the survey

The results will depend on many factors - the term of delivery, birth weight. The norm for all children of different months of life is the following parameters.

1. All parts of the brain should be symmetrical in size and homogeneous in composition.
2. Furrows and convolutions have clear contours.
3. The absence of fluid in the interhemispheric fissure, and its dimensions do not exceed 3 mm.
4. The choroid plexuses of the ventricles are hyperechoic and homogeneous.
5. The size of the lateral ventricles is normal: anterior horns - up to 4 mm, occipital horns - 15 mm, body - up to 4 mm. Third and fourth ventricles - up to 4 mm.
6. The norm of a large tank is up to 10 mm.
7. There should be no seals, cysts and neoplasms.
8. Shells of the brain without changes.
9. The normal size of the subarachnoid space does not exceed 3 mm. If it is larger, while there is an increase in temperature and frequent regurgitation, then a disease such as meningitis can be suspected. If there are no concomitant symptoms, all other examinations are normal, perhaps this phenomenon is temporary.

The ventricular cavity should not be enlarged. Their increase indicates diseases such as hydrocephalus, rickets. During hydrocephalus, the child has a large head, a swollen fontanel. This violation causes frequent headaches, mental and physical underdevelopment.

The contents of the lateral ventricles (right and left) is cerebrospinal fluid. With the help of special openings, they are connected to the third ventricle. There is also a fourth ventricle, which is located between the cerebellum and the medulla oblongata.

In the lateral ventricles, the cerebrospinal fluid combines, after which it moves into the subarachnoid space. If such an outflow is disturbed for some reason, hydrocephalus occurs.

Asymmetry of the lateral ventricles (dilation) is observed in case of an increase in the amount of fluid. The disease can be diagnosed in children who were born prematurely, since the size of their lateral ventricles is larger.

If asymmetry of the lateral ventricles is detected on the NSG, the size is measured, the quantitative and qualitative characteristics are determined.

The main reasons due to which the ventricular cavity expands include hydrocephalus, trauma to the skull and brain, CNS lesions and other malformations of newborns.

A cyst of the septum pellucidum is usually detected from birth. The transparent septum is a thin plate, consisting of brain tissue. Between these plates is a cavity resembling a gap. A cyst of the transparent septum is a cavity inflamed with liquid. The cavity accumulates and begins to compress adjacent tissues and vessels.

A cyst of the transparent septum is found on the NSG in almost all premature babies. After a while, it may disappear. If a cyst of the transparent septum was detected immediately after birth, then in most cases no special drug therapy is prescribed.

In the event that a cyst of the transparent septum has arisen due to injury, inflammation or an infectious disease, immediate treatment is required. Associated symptoms (pain in the head, impaired vision and hearing) may occur.

During the NSG, which is carried out every month after the discovery of a violation, the dynamics of the development and growth of a cyst of the transparent septum is determined. Depending on the growth rate and the cause of the cyst, further treatment will depend. Basically, drugs are prescribed that release this cavity of the brain.

If any violations were found during the NSG, a decision on medical withdrawal of all vaccinations is possible. Vaccinations can worsen the condition, so after the examination, you need to visit a neurologist.

Deciphering and clarifying the diagnosis is carried out by a neurologist. Only he can prescribe the correct treatment and observe the development of the disease in dynamics. He will also prevent possible complications and prevent other violations.

The study of the pathology of the brain of an infant has undergone significant changes with the introduction of neurosonography. This method has sufficient information content and is completely safe. The components of the brain, thanks to the use of this diagnostic method, are subjected to ultrasound, which makes it possible to correctly assess the brain structure, as well as timely detect pathological changes in the brain of an infant.

What is neurosonography?

This is the name of an effective examination of a newborn child using special devices. The physiological features of the structure of the skull of a newborn child make it possible to provide such a method. The bones of the skull of the baby have not yet been completely formed, and therefore the implementation of this kind of research is completely painless for him.

This diagnostic method does not differ significantly from ultrasound. Ultrasonic waves quite calmly and without obstacles penetrate to the baby's brain through a non-overgrown fontanel. If it slowly heals with age, there are more opportunities for the use of neurosonography. A favorable prognosis for a baby is the more likely, the earlier the pathology of the development of the child's skull is detected.

What is it made for?

The procedure under consideration is performed on a newborn child through cartilaginous areas on the skull that have not yet ossified, which are called fontanelles. In total, the child has four of them. In front of the cranium is the largest of them, through which, as a rule, the examination of the brain passes.

The study of the brain of an infant using neurosonography is shown in a number of cases, among which the following should be highlighted:

• various stages of prematurity;
• the mother had problems with labor, among which are the improper location of the fetus in the uterus, excessively fast or slow labor, the improper position of the fetus, which it occupies in the womb;
• prolonged lack of oxygen for the fetus in the womb or various stages of its suffocation during labor;
• all kinds of pathologies of labor activity or infectious lesions transferred during childbirth:
• the birth of a child by performing a caesarean section on the mother;
• insufficient compatibility of the Rh factor of the child and the mother;
• retraction or protrusion of the fontanel;
• possible concerns regarding the presence of pathologies in the structure of the chromosomes of the child.

Neurosonography is performed to confirm or refute any of the diagnoses.

How often can I do neurosonography of the baby?

The examination is not fraught with any harm to the health of the child. Additionally, it is not required to prepare the infant's brain for neurosonography.

Previously, the baby had to be put under general anesthesia before starting the procedure. This was practiced in pathological conditions of the child's nervous system and other mental disorders. Neurosonographic diagnostics does not require this. Even wakefulness and increased physical activity of the child do not interfere with its implementation.

In view of all of the above, it should be concluded that the event in question can be carried out for infants with virtually no restrictions on the time and number of procedures. In practice, it is generally accepted that the optimal number for such operations, which is sufficient to clarify all the nuances of the baby's condition, is one session per week.

What does neurosonography of the baby show?

The results of the study are presented in the form of a protocol, which contains the following data:

• symmetry of the cerebral hemispheres of the child or the complete absence of it;
• the distinctness of the location of the convolutions in the infant's cerebral cortex;
• indicators of symmetry of the ventricles of the child's brain:
• the clarity of the shape of the sickle-shaped process of the baby's brain:
• trapezoidal shape of the contours of the cerebellum;
• the presence or absence of fluid in the cavity between the two hemispheres of the brain;
• indicators of homogeneity of the plexus of the vessels of the child's brain;
• the presence of cysts and the softness of the structure of the medulla of the child.

Indications for infants of various ages

There are various indications for infants to carry out the procedure in question.

From birth to 2 months

For children of this age category, the indications for brain scan sessions are usually:

• protracted birth of the mother of the baby;
• birth by caesarean section;
• defects in the structure of the child's skull.

A timely procedure provides an accurate determination of the cause of the incident, as well as possible ways to eliminate the situation. In some cases, temporary hospitalization of the child is indicated for the neurosonography procedure.

From 2 months to six months

For children of this age group, it is realistic to perform the neurosonography procedure for the following indications:

• violation of the symmetry of the structure of the child's brain;
• brain damage by infections in the first months after the baby is born;
• increased nervous excitability.

Based on the results of the assessment of the brain tissue of the infant during the indicated period of his life, measures are prescribed to change the current situation and take measures to bring the child's brain activity to a normal state.

Brain defects in infants available neurosonography

Brain defects in infants that can be determined by neurosonography are detected after the study itself.

Norm

During the study, the state of some parts of the brain of the baby and the size of certain areas are determined. The following parameters are considered normal:

• dimensions of the anterior horn of the lateral ventricle of the brain - from 1 to 2 mm;
• the depth of the body of the anterior horn is up to 4 millimeters;
• the size of the gap between the hemispheres of the brain - up to 2 mm;
• the volume of the third ventricle of the brain - up to six mm;
• the size of the subarachnoid space is up to three millimeters;
• the volume of the large cistern of the brain is from three to six millimeters.

Minor deviations in the dimensions of these organs up to one millimeter are allowed.

Pathologies

Pathology is considered to be a significant excess of the above values ​​(from 3 mm or more). However, this condition of the newborn is not a reason for panic. Any pathology can be cured if it is detected in time and timely treatment is started.

As for formations in the form of a cyst, they resolve themselves in the vast majority of observed cases. They only require periodic monitoring.

Conducting research in a hospital

A study using neurosonography of small patients may well be performed in a hospital inpatient setting. This requires the necessary sequence of actions to be followed.

Preparing the baby for the procedure

Special preliminary preparation of an infant for this procedure is not required. It is enough that the child is not hungry and does not feel thirsty. In addition, if the child falls asleep, he does not have to be specially woken up. Moreover, it will greatly facilitate the passage of neurosonography, both for medical personnel and parents. The results of the operation will be available immediately after the session, a maximum of a couple of minutes after it.

Process

The very nature of the course of the neurosonography process does not differ significantly from the procedure for performing an ultrasound examination. The child is placed on a flat couch, after which the points of attachment of the sensors to his head are lubricated with special compounds. Then comes the procedure itself.

The doctor gains access to the baby's brain through the fontanel located on the parietal part of the head, as well as through the area of ​​​​the opening on the back of the head. To decipher the results of the study, a doctor of sufficient qualification is required.

Neurosonography of the baby: decoding

Deciphering the results of each session of the study consists in listing the structures under consideration, indicating their symmetry and general condition. The data is given as follows:

• symmetrical or asymmetric cerebral hemispheres;
• how well the visualization of the grooves in the infant's brain is done;
• shape and arrangement of the crescent of the brain;
• the volume of fluid in the gap between the hemispheres of the brain;
• the volume of the cerebellar plaque and its general condition.

The table with the results of neurosonography is kept by the specialist performing it from one to three months.

Modern medicine allows physicians to conduct ultrasound examinations of organs to get their picture. Ultrasonic waves are high-frequency vibrations that pass through various structures of the human body. Some zones do not pass such waves, some pass completely. For example, there is such a method of examination as neurosonography.

A little about neurosonography

Neurosonography is a study of the organs of the central nervous system. This term consists of three Greek words: neuron (nerve), grapho (image), sonus (sound). Thus, the combination of these words makes it possible to immediately understand the principle of neurosonography (NSG): brain image. Sometimes this method is called ultrasonography, which means the same thing.

Some people think that this study is carried out through the fontanelle (the area of ​​the newborn's head where the cranial bones have not yet converged) to study the brain. In fact, this is not entirely true: the NSG combines a whole group of studies

• soft tissues of the head;
• brain;
• spine;
• skulls.

The most common method is neurosonography of the brain of newborns. Every parent should know what neurosonography is and what the principle of the study is.

Features of the nervous system of newborns

When a child is born, its nervous system and the structure of the bones of the skull are very different from those of children older than a year and adults. A feature of the CNS of a newborn is that only 25% of brain neurons are fully developed. By six months, 66% of nerve cells are already able to function, and in a year - almost all cells. From this it becomes clear that the most intense period development of the nervous system is under three months of age.

Also, the child’s skull is not completely closed at first, but has connective tissue formations called fontanelles. Until they are covered with bone tissue, neurosonography should be performed. This procedure allows you to see the pathology of the central nervous system of the baby in the initial stages, which is important in the diagnosis and further treatment.

NSG of the brain of newborns

Neurosonography: what is it? Such a study is a reliable and effective way to get an idea about the structure of the brain and its functioning. For brain screening of newborns, neurosonography is most often prescribed. During the procedure, the doctor evaluates the state of the brain, its activity, the size of individual parts. And the most important thing is that the NSG is able to identify congenital defects of the central nervous system.

Ultrasonic waves penetrate only through soft tissues, and therefore parents should hurry with the procedure: the fontanels can be closed by the cranial bones. In order to protect the baby from serious illnesses, it is necessary to conduct neurosonography of the baby. After a year, this procedure will be impossible to do.

A planned procedure is prescribed when the child is 1–1.5 months old. Ultrasound is part of a comprehensive examination, which includes an examination of the heart, thymus, joints and abdominal cavity.

Indications

And also neurosonography is performed on a newly born baby, if he has convex or sunken fontanel, there is no first breath and pulsation in the fontanel. Even identified pathologies during pregnancy serve as a reason for examining the brain, especially if the mother drank, smoked or took drugs during pregnancy.

The procedure is mandatory for those who were born prematurely, as well as if the mother and child have a different Rh factor.

What diagnoses are specified after the ultrasound? These include meningitis, Aper's syndrome, encephalitis, ischemia, rickets, cerebral palsy. Strabismus, non-standard head size, hemorrhage in the eyes, increased intracranial pressure can contribute to this.

How to prepare your child for the procedure

Newborn to brain examination procedure no need to cook. It doesn't matter if the child was fed before or not. But in order for him to be calm during an ultrasound scan, he needs to be shaken in his arms, calmed down, fed. So the baby will allow you to examine his head before the procedure. Since the child does not yet know how to hold his head himself, the mother of the baby will do this so that he does not turn his head in different directions.

Before neurosonography, the fontanel is lubricated with a conductive gel that does not cause allergic reactions. This gel facilitates inspection and eliminates interference due to the sliding of the transducer over adjacent tissues. Within a few minutes, the doctor conducts an ultrasound, changing the angle of the device. As a result, an image of the brain is displayed on the screen, on the basis of which the doctor makes a conclusion.

The course of the procedure

For ultrasound, a large anterior fontanel is suitable. Because the skull bones of older children become very dense, then the ultrasonic waves do not pass through them. In addition to a large fontanel, they use thin temporal bone, posterolateral and anterolateral fontanel, occiput (but with maximum flexion of the baby's head). Such areas are designed to study the posterior and central parts of the brain.

In what cases is this or that area used? In premature babies, the lateral fontanelles are not yet protected by bone, and therefore ultrasound is done through them. And in full-term babies, the temporal bone is often used: it is quite thin in order to miss the ultrasound.

Deciphering the results

The doctor writes on the card about the structure of brain tissue. The symmetry of the structures indicates that everything is normal, and the asymmetry indicates the presence of pathologies. The clear convolutions and furrows of the brain say that everything is fine. . The ventricles are also examined: they should be homogeneous and the same, there are no inclusions. But if there is a hemorrhage in the description of the ventricles, then the word “flakes” is written. The cerebellum should have a symmetrical trapezoidal indentation. It should be in the back of the head in the cranial fossa. There should be no fluid between the hemispheres, and all vessels normally have a uniform structure. The vascular plexuses are homogeneous and hyperechoic.

The following normal sizes of parts of the brain are distinguished:

• body of the lateral ventricle from 2 to 4 mm;
• the size of a large tank is not more than 5 mm;
• the size of the subarachnoid space should be from 1.5 to 3 mm;
• the depth of the anterior horn of the ventricle is not more than 2 mm;
• third ventricle up to 5 mm.

An ultrasound of the brain also helps to determine the presence of cysts or other neoplasms. If the doctor nevertheless revealed a pathology, you must first contact a neurologist. Because such formations can be life-threatening for the baby.

Pathologies

In the vascular plexuses there may be cysts - bubbles with liquid, formed in the places of production of cerebrospinal fluid. They can appear when the child is in the womb, and also form due to birth trauma. In newborns, cysts go away on their own, but sometimes pathologies can be serious.

Around the ventricle may form subependymal cysts. They do not cause particular concern to the baby, but you need to find out the causes of the neoplasm. Because such cysts can cause ischemia and hemorrhage located in the tumor area. Such benign formations should be constantly monitored by doctors.

If a hemorrhage is found in some area of ​​the child's brain, then ischemia may be the cause. If the baby is not treated, then a violation of brain functions begins, which will affect his future life. To minimize the risks, neurosonography and doplerometry are prescribed.

Arachnoid cyst- a small sphere, also filled with liquid. It does not pose a danger when it does not grow. But if the cyst begins to develop, then surgical intervention is required.

Due to tumors, as well as large cysts and hemorrhages, a hypertensive syndrome can form. It requires a visit to a doctor, because it can lead to complications.

When one or more of the ventricles of the brain dilate due to the accumulation of water, hydrocephalus begins. A child with such a pathology has a strange head shape: it is too big, and the forehead seems to roll out. Hydrocephalus must be treated with intensive therapy because this condition can be life-threatening for the baby.

The most common pathology is intraventricular hemorrhages. They are located in the central regions of the brain. With this disease, it is the NSG that is used, and not the tomography, because it shows a more accurate image of the damaged area. Intraventricular hemorrhages are typical for premature babies: the earlier the child was born, the stronger the hemorrhage.

It is worth mentioning the parenchymal hemorrhage. It develops in the first days of life, but can take place even in the womb. Pathology can appear due to infection of the brain, problems with blood clotting, and also due to hypoxia. Isolated hemorrhages are usually accompanied by hemolytic disease, which occurs due to the incompatibility of the Rh factor of the child and mother. After the hemorrhage resolves, a porencephalitic cyst is formed. This disease is dangerous because the part of the brain affected by it is not restored. And the worse the lesion, the more neurological pathologies will arise.

Numerous studies show that NSG - safe examination method vessels of the brain and neck. Before the invention of neurosonography, newborns were examined using computed tomography, which requires anesthesia. No preparation is required before neurosonography. Ultrasound takes 15-20 minutes, and this examination can be performed several times without harm to health.

Today, ultrasound diagnostics is actively developing, and it even wins more and more areas from radiology, for example, the gastrointestinal tract and hip joints. Now no one is surprised that a child can get acquainted with ultrasound when it is only in the womb. Therefore, parents should not worry if an NSG is prescribed to a newborn: this allows you to detect dangerous diseases in the early stages without harm.

Some parents neglect this method of examination. And why worry if the child, according to the testimony of doctors, was born strong? It is worth remembering that outwardly the child can be healthy, and even at the appointment with a neurologist, no abnormalities will be found. The baby may even develop well, but at some point undiagnosed disease suddenly makes itself known. And the parents lost too much time due to the fact that they did not sign up the baby for neurosonography. Therefore, such events must be done on time, because his future development depends on the health of the baby.