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This next infant is a one week old infant who came

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to screening head ultrasound.

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Uh, it was a premature twin infant with, uh,

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prenatal concern for twin, twin transfusion syndrome,

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but doing well clinically.

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So at one week of life we have a head ultrasound.

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We are starting with our baby head transducer, so

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that small footprint, uh, phased array,

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mid-frequency transducer.

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We start in the Corona plane

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and we're going anterior to posterior.

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So you can see this is a premature infant.

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We have just a little bit of, um, cingulate, sulcus starting

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to form, and our, uh, sylvan fissure is starting

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to curve kind of like a whales tail,

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so it's not no longer boxy.

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We know this infant is at least 26 weeks gestational age.

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So as we're coming anterior posterior,

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I'm looking at the ventricles.

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Those look nice and symmetric.

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We do have a cavem septum, pullum, a normal structure.

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Um, we're a little bit off plane here.

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I'm, I'm assuming the tech had a little bit of a hard time,

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um, imaging exactly midline in this infant.

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But as we're coming posterior, I don't see any structures

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that are as bright

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or brighter than the choroid plexus on either side.

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We'll, eng we are angling off

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to the right side looking at these extract AAL spaces along

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the middle cranial fossa on the right.

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And I don't see any abnormal collections,

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no abnormal hyper genicity or, or architectural distortion.

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Uh, the sonographer is showing me

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that the superior dural venous sinus superior

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sagittal dural venous sinus is patent on color flow imaging

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on both the coronal plane and the sagittal plane.

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Um, our midline sagittal view, we have this beautiful,

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well-formed corpus callosum.

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This is our ca septum lucidum.

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Here we have our prial occipital sulcus up here.

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Our tentorium has no abnormal hemorrhage or anything.

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Midbrain. Um, ponds, uh, medulla AMLO

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structures look okay, as does the cerebellum.

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Uh, cistern of magnas not normally enlarged.

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No abnormal genic material in it.

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As we go off to the right side, no abnormal genic foci

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or architectural distortions.

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Um, we have normal, uh, vessels.

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Uh, our circle of willa structures are filling in nicely

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with color doppler imaging on our trans mastoid view.

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So our view, looking at posterior fossa structures,

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our cerebellum is nice and heart shaped.

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We have a prominent

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but not crazy, a large cy sternum magna,

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nothing abnormally genic along the tentorium.

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And what we see of the temporal horns

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bilaterally look normal.

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We have a nice normal fourth ventricle, nice normal

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cerebellar verus at midline there.

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And again, our superior sagittal dur venous sinus fills in

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normally with color and we don't have enlarged extra axial

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spaces at the vertex.

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These last images are showing us these linear

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genic foci in the cavem

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Septum lucidum. So

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at midline on this linear high frequency transducer,

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we can see that detail beautifully.

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So here they are, these branching echogenic foci.

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So the next thing we're gonna do is come

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to our linear high frequency, uh, sagittal cinematic images

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to get a better look at those branching echogenic foci.

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So as we're going from the patient's right side

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to the patient's left side, as we come through midline,

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we see these branching genic foci in the

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cave septum lucidum.

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So these are normal variant septal veins.

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So, uh, embryologic structures that will involute over time.

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They are not syne eye related to prior infection,

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prior ventriculitis.

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These are normal structures in this infant.

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Let's go to our coronal cinematic image to show similar,

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similar findings.

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So as we're scrolling from anterior to posterior,

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we see these thin, linear

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or curve linear genic foci extending

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through the cavem septum lucidum

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as we scroll from anter to posterior.

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So normal variant septal veins in this, uh, lovely,

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nice normal twin infant.