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Definition

What is a head ultrasound?

Head ultrasound works by reflecting sound waves to capture images of the brain and a fluid-filled space (ventricles) through which cerebrospinal fluid (CSF) flows. This test is generally performed on young infants to review complications that occur due to preterm birth. In adults, a head ultrasound is performed as a visual during brain surgery.

Ultrasound waves cannot penetrate bone, so ultrasound tests that are used to monitor the brain cannot be performed after the skull (cranium) has grown. Head ultrasounds can be done in babies before their skull bones have grown or in adults who have had open surgery. This test can also be done to monitor problems with the brain and ventricles of babies until 18 months of age.

Head ultrasound for babies

Complications of preterm infants include periventricular leukomalacia (PVL) and cerebral hemorrhage, including intraventricular hemorrhage (IVH). PVL is a condition in which the brain tissue around the ventricles is damaged, possibly due to low oxygen levels or due to blood flowing to the brain before, during, and after childbirth. IVH and PVL increase the risk of disability in infants, which may include mild, or delayed motor nerve movement, cerebral palsy or intellectual disabilities.

IVH is more common in premature babies than in babies born normally. When IVH appears, it will usually appear on days 3 to 4 after birth. Most cases of IVH can be detected by ultrasound of the head from the first week after a week of birth. In contrast, PVL takes several weeks to detect. For these cases, a head ultrasound may need to be repeated 4 to 8 weeks after birth if PVL has been estimated. Several head ultrasound tests can be done to evaluate areas of the brain.

A head ultrasound may also be done to monitor the increase in the size of the baby’s head, detect infections in the brain (such as encephalitis or meningitis), or check for brain problems that are present at birth (such as congenital hydrocephalus).

Head ultrasound for adults

A head ultrasound may be done in adults to help find brain masses. Since ultrasound cannot be done after the skull bones have fused, it can only be done in adults who have had open surgery on the brain.

When should I have a head ultrasound?

In infants, head ultrasound serves to:

  • evaluate hydrocephalus, or enlarged ventricles, a condition caused by several factors
  • detect bleeding in brain tissue or ventricles. this condition is called intraventricular hemorrhage (IVH)
  • assess whether there is damage to the brain tissue surrounding the ventricles, a condition known as periventricular leukomalacia (PVL)
  • evaluate congenital defects
  • locate the tumor infection site

In adults, a head ultrasound is performed to determine the brain mass during surgery, for safe disposal

Precautions & warnings

What should I know before having a head ultrasound?

Because ultrasound cannot penetrate bone, head ultrasound can only be performed on babies whose skull (cranial) bones have not grown together. However, duplex doppler ultrasound can be performed to evaluate blood flow in the brains of children and adults.

Periventricular leukomalacia (PVL) usually cannot be detected until several weeks after birth. Therefore, head ultrasound is usually done 4 to 8 weeks after birth. Because a head ultrasound may find specific areas in the brain that may be affected by PVL, this test can be repeated after a few weeks. Infants with PVL or intraventricular hemorrhage (IVH) may grow normally or have disabilities, including cerebral palsy or intellectual disabilities.

Process

What should I do before undergoing a head ultrasound?

No special preparation is required before taking this test. Adults may be asked to stop taking nicotine-containing products for 30 minutes to two hours before the transcranial doppler ultrasound test. Products containing nicotine can cause blood vessels to shrink and give inaccurate results. The doctor will provide specific information about this test. If the baby is more than a few months old doing this test, it will allow the baby to feel a little hungry. The baby may be fed during this test so that he can feel comfortable and calm during the test.

How is the head ultrasound process?

This test is performed by a radiologist who is an expert in interpreting the test results or by a sonographer. For infants, head ultrasound may be performed at the bedside of the neonatal intensive care unit (NICU). The baby lies down, the transducer is moved across the weak point (fontanelle) above the head. You may be asked to hold your baby during the test. An image of the brain and fluid spaces (ventricles) can be seen on a monitor. For adults, a head ultrasound is done during brain surgery to find brain masses. Head ultrasound tests are usually done for 15 to 30 minutes.

What should I do after undergoing a head ultrasound?

Subsequent tests may also be needed, and the doctor will explain why the retest is required. Sometimes, follow-up tests are done because a finding is suspicious or needs to be questioned through special imaging techniques. Follow-up tests are also needed if abnormal changes occur while being monitored.

Follow-up tests are sometimes the best way to find out if medication is working or if abnormalities persist.

Explanation of Test Results

What do my test results mean?

Normal result

Normal brain size and shape.

The size of the brain fluid space (ventricles) is normal.

Normal brain tissue. There is no bleeding, abnormal growths of infection, or lesions also do not appear.

Abnormal results

There is bleeding in the brain, which indicates intraventricular hemorrhage (IVH). Retesting is often done to check for bleeding or to find out what is causing the bleeding. There is a suspicious area or lesion around the ventricles of the brain. This may be a symptom of periventricular leukomalacia (PVL), a condition in which brain tissue is damaged. The brain and ventricles may enlarge and build up large amounts of cerebrospinal fluid (CSF). This indicates hydrocephalus. Abnormal growths may occur, which can indicate a tumor or cyst.

There are suspicious areas in the brain, which may indicate encephalitis or meningitis.

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