0:00

Okay, so we'll start with this head ultrasound.

0:03

This was a term infant who came to imaging

0:05

because of concern for coagulopathy.

0:09

So we started in this infant for some reason

0:12

with a linear high frequency transducer.

0:14

We don't have any baby head transducer images,

0:16

but uh, this nicely illustrates the finding.

0:19

So this is definitely a term infant

0:21

because number one, our sylvan fissure is,

0:24

is very whales tail.

0:26

It is not box-like at all.

0:27

And also we see cingulate sulcus

0:29

very well developed in this infant.

0:32

So as we're coming from anterior to posterior, I'm looking

0:34

to see our ventricles are normal size.

0:36

There's normal configuration.

0:38

We do have a small kivu septum tum,

0:41

which is normal in a term infant.

0:43

Um, we do have, um, our corpus callosum here

0:48

as we go posterior.

0:49

I'm looking at our temporal thorns.

0:51

Uh, the hippo campi look normal in morphology.

0:53

There's no midline shift

0:55

and then no structure aside,

0:58

aside from the SoCal content is more echogenic than these

1:02

choroid plexus on either side.

1:05

Um, we do our off angle imaging,

1:07

looking at the middle cranial fossa,

1:09

extra axial spaces in parenchyma.

1:12

I don't see any sort of abnormal collections in

1:15

the extra AAL spaces.

1:17

Um, as we go to our sagittal images,

1:20

I love this midline view.

1:22

So we see our corpus Callum nice and well-formed.

1:26

We see our brainstem structures, we see our, uh, cerebellum

1:30

and nothing abnormal epigenic.

1:32

Nothing causing mass effect along the

1:35

tentorium on this image.

1:37

Um, but there is a cystic structure that I'm seeing now here

1:42

near the, uh, it's kind of teardrop in shape

1:45

and it's right near the apex

1:47

of the frontal horn lateral ventricle.

1:49

So our sonographer, thank goodness, has labeled

1:52

that this is the right side of this infant,

1:54

this sort of teardrop structure.

1:56

She has measured it for us to help us see it.

2:00

Here it is on the sagittal plane.

2:02

It's a little bit more challenging

2:03

to see in the coronal plane.

2:06

Um, as we're going to, uh,

2:08

the sonographer put color doppler image.

2:10

It does not fill in with color as we would expect this,

2:13

this, uh, normal variant to do.

2:16

And then as we're going to the left side on this infant,

2:19

we see a very similar, uh,

2:21

almost symmetric similar teardrop shape shaped

2:25

cystic structure near the, uh, sort of apex

2:28

of the frontal horn lateral ventricle.

2:30

Again, there's a measurement on that.

2:34

Um, as we're looking at our extra axial spaces,

2:36

our superior sagittal dur venous sinus

2:39

fills in normally with color.

2:40

Our x extra axial spaces are not enlarged.

2:43

Here it is on the sagittal plane.

2:45

This is the sector transducer that this,

2:47

that the sonographer has had to switch to.

2:49

In order to get this to fill in with collar doppler,

2:52

we see our anterior cerebral artery coming around anterior

2:55

to the corpus callosum.

2:57

Last but not least, we have

2:58

Our heart shaped cerebellum.

3:00

So, uh, one cerebellar hemisphere,

3:02

the second cerebellar hemisphere, nothing abnormally genic

3:06

or causing the as effect along the tentorium.

3:08

And we see a little bit of our fourth

3:10

ventricle here on this view.

3:12

We see the fourth ventricle much better

3:13

and cerebellar verus here in the middle.

3:15

So, um, this is, I'll show you the,

3:20

this is a nice example

3:21

of really pretty symmetric prenatal cyst.

3:24

So again, these are normal variant cystic structures.

3:27

Uh, a remnant structure that will resolve, uh,

3:30

will involute over time.

3:32

We can see it at MR as well if the infant goes

3:35

to MR Imaging for some other reason.

3:38

Um, this is a normal head ultrasound

3:40

with incidental conal cyst.

3:41

So there's the left conal cyst on the sagittal cene coming

3:46

over to the right side.

3:48

The right side is smaller and more challenging to see,

3:50

but here's that right side conal cyst in this infant.

3:54

So basically a normal head ultrasound

3:56

with just incidental normal variant prenatal cyst.

4:00

I also have to point out one other finding on this,

4:02

on this infant, and that is we do have a little bit

4:06

of lenticular, right vasculopathy.

4:08

So we see these genic, linear foci in

4:12

that right thalamus on this right side.

4:15

Going back to the coronal syne image, a little harder

4:19

to see on the coronal,

4:20

but here's, uh,

4:22

that lul right vasculopathy on that right side.

4:25

Again, that's basically a normal finding.

4:28

Um, no, there's, uh, it's associated with

4:31

multiple abnormalities, but also it can be seen

4:34

in normal infants.

4:35

So in the absence of something else abnormal on the

4:38

ultrasound or something else abnormal, clinically,

4:40

we will just call that a normal head ultrasound.