ABSTRACT
Major technological advances have occurred since the late 1950s when ultrasound was first utilized by Leksell in the assessment of intracranial contents1. The amplitude mode (A-mode) scanning and static gray scale imaging are of only historical interest. The linear array units with large transducers have now been replaced by sector and linear, high frequency, small head transducers that comfortably fit over the fontanelle. The use of water baths and stand-off pads has been replaced by application of standard direct contact coupling gel used for all ultrasound scanning. The patient, who is often premature and in distress, is scanned by portable units brought to the nursery The examination time has shortened and, in experienced hands, takes 5 to 10 minutes2. The resolution of images since Leksell’s use of ultrasound in 1956 (A-mode sonography1), and the pioneering work of Kossoff and colleagues3, and Garrett and colleagues4 on ultrasound of the normal and hydrocephalic neonatal brain have markedly improved with the real-time gray scale imaging5-43. The inclusion of color and pulsed wave Doppler has added to the versatility of ultrasound in imaging through the cranium44-55 and the understanding of vascular anatomy of the brain. Ultrasound has the distinct advantage over computed tomography or magnetic resonance imaging in its portability, being inexpensive, and non-invasive without sedation1018,19. This makes it suitable for imaging neonates in intensive care units (NICU or ICU).
