Head ultrasound: cranial and brain ultrasound diagnostics
Ultrasonography of the brain is a quick and informative ultrasound method for examining the structures of the brain in children under one year old. It allows you to visualize the child’s brain through an open large anterior fontanel. Ultrasonography of the brain can be used in adults with defects in the bones of the skull as a result of injuries or surgeries, if these holes can be used instead of the open fontanelle.
This method of examination is preliminary, in the detection of pathology, a follow-up examination of the patient (CT or MRI) is necessary.
Indications and contraindications for cranial ultrasound
The examination is shown for premature newborns, children with signs of disorders of the nervous system, who have suffered a brain injury (including a birth injury) or hypoxic damage to the central nervous system. Clinical neurology uses ultrasonography as a screening method for mass screening for the early detection of congenital CNS pathology, which enables timely treatment, increase its effectiveness and avoid complications.
Ultrasonographic screening is most important in children under 3 months of age, when pathological changes that are not diagnosed at birth are possible (for example, slowly progressing hydrocephalus, gradually increasing cysts of the brain).
Ultrasonography is prescribed by a neurologist for emergency rapid diagnosis of the nature and location of pathological changes in the brain, if it is impossible to examine with CT-scan or MRI (lack of equipment, severe condition of the child, lack of time, etc.).
It is used for monitoring and evaluation in the dynamics of the state intracranial structures. This is necessary for frequent repeated examinations of a patient with a diagnosis confirmed on CT or MRI, after neurosurgical operations, in the treatment of hydrocephalus and other diseases.
During neurosurgical operations or diagnostic punctures of the intracerebral formations (abscess, cyst, swelling, etc.), ultrasonographic neuronavigation is used, which allows manipulation in the cranial cavity under visual control.
Contraindication is the presence of severe deformities of the skull in the anterior fontanel and temporal bones, which makes it difficult to conduct ultrasonography and can distort its results.
Head (cranial) ultrasound: Method of conducting
Examination does not require the preparation of a child. It is carried out according to the method of conventional ultrasound examination in three different ways:
- through the open anterior fontanelle (over-epoch ultrasonography),
- through the temporal and other bones of the skull (transcranial ultrasonography),
- by combining the first two methods (transcranial ultrasound ultrasonography).
Since dense skull bones poorly pass ultrasonic signals, the examination is traditionally carried out through the anterior fontanel. However, it does not allow you to fully view the entire space inside the skull.
The accessibility of the study of these or other brain structures depends on the size of the fontanel and their remoteness from it. In this case, areas that are located under the bones of the cranial vault and the posterior parts of the brain are often not examined.
For their study, transcanial ultrasonography is used. It is carried out in places where the bones of the skull are thinner and let in ultrasound, for example, the scales of the temporal bone, the bones in place of the closed lateral fontanels (anterior located in front of the ear, and the posterior behind the ear). In addition, it is possible to use a large occipital opening.
To do this, head the child as much as possible forward to the chest, and the ultrasonic sensor is installed under the back of the head. The combined use of overgrowth and transcranial ultrasonography makes it possible to obtain the most complete information about the structures of the brain and pathological changes in them.
The examination lasts 5-15 minutes. In rare cases, during ultrasonography, false positive results can be obtained that are not confirmed by a pre-examination on a tomograph, or false-negative results-unidentified pathological abnormalities.
Ultrasound of the brain: cost in USA
The study belongs to the category of inexpensive diagnostic manipulation, conducted in specialized medical institutions. Usually in USA state clinics and hospitals prices for ultrasound of the brain are more accessible than in private medical-diagnostic centers.
The technique is often used for emergency indications, which can influence pricing. When carrying out operations on the brain and puncturing intracerebral formations using ultrasonographic neuronavigation, the total cost of the procedure is calculated taking into account the price of the intervention.