3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Head Ultrasound in Neonate
I. Brain Anatomy
Evita Karianni Bermanshah Ifran
Pediatric Imaging Working Group
Indonesian Pediatric Society
1
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Introduction
Head ultrasound is considerably easier to learn than
echocardiography because cerebralanatomy more logical and
symmetrical than the heart. However, there are pitfalls,
particularly with interpretation of increased echogenicity.
Anatomy is the important thinks if you want to learn
ultrasound. The only way to learn by understanding the
spatial anatomy. You need to understand the brain anatomy,
each structure related to others in 3D dimension
2
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Cerebral anatomy
External anatomy
Internal spatial anatomy
Vascular anatomy
3
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
External anatomy
Fissure Interhemispheric
Superior sagittal sinus
Inferior sagittal sinus
4
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
External anatomy
Fissure Interhemispheric
Superior saggital sinus
Inferior saggital sinus
5
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
External anatomy
Fissure Interhemispheric
Superior sagtital sinus
Inferior saggital sinus
6
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
7
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
8
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
9
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
10
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
11
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
12
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
13
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Right view
Frontal lobe
Parietal lobe
Occipital lobe
Temporal lobe
Central sulcus
Pre-central gyrus (motoric
cotex)
Post-central gyrus (sensoric
cortex)
Lateral sulcus (sylvian
sulcus)
14
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Back view
Parietal lobe
Occipital lobe
Tentorium cerebelli (dural
fold separated cerebelli from
occipital cortex)
Cerebellum (at the base of
brain in the posterior fossa
of the skull) is made up two
cerebellar hemisfer
Cerebellar vermis, situated
medially
15
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Back view
Parietal lobe
Occipital lobe
Tentorium cerebelli (dural
fold separated cerebelli from
occipital cortex)
Cerebellum (at the base of
brain in the posterior fossa
of the skull) is made up two
cerebellar hemisfer
Cerebellar vermis, situated
medially
16
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Back view
Parietal lobe
Occipital lobe
Tentorium cerebelli (dural
fold separated cerebelli from
occipital cortex)
Cerebellum (at the base of
brain in the posterior fossa
of the skull) is made up two
cerebellar hemisfer
Cerebellar vermis, situated
medially
17
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Back view
Parietal lobe
Occipital lobe
Tentorium cerebelli (dural
fold separated cerebelli from
occipital cortex)
Cerebellum (at the base of
brain in the posterior fossa
of the skull) is made up two
cerebellar hemisfer
Cerebellar vermis, situated
medially
18
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Back view
Parietal lobe
Occipital lobe
Tentorium cerebelli (dural
fold separated cerebelli from
occipital cortex)
Cerebellum (at the base of
brain in the posterior fossa
of the skull) is made up two
cerebellar hemisfer
Cerebellar vermis, situated
medially
19
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Foramen of Monro
(interventricular
foramen)
Third ventricle
Aqueduct sylvii
Forth ventricle
(running between
cerebellum and
brain stem)
20
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Foramen of Monro
(interventricular
foramen)
Third ventricle
Aqueduct sylvii
Forth ventricle
(running between
cerebellum and
brain stem)
21
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Foramen of Monro
(interventricular
foramen)
Third ventricle
Aqueduct sylvii
Forth ventricle
(running between
cerebellum and
brain stem)
22
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Foramen of Monro
(interventricular
foramen)
Third ventricle
Aqueduct sylvii
Forth ventricle
(running between
cerebellum and
brain stem)
23
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Foramen of Monro
(interventricular
foramen)
Third ventricle
Aqueduct sylvii
Forth ventricle
(running between
cerebellum and
brain stem)
24
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
25
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
26
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
27
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
28
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
29
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Ventricle system
Right or left lateral ventricle
(crescent shaped):
frontal horn
central horn
posterior horn
inferior horn
Inter ventricular foramen (
foramen of Monro)
Choroid plexus (against
anterior wall of posterior
horn lateral ventricle)
30
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
31
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
32
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
33
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
34
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
35
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Basal ganglia is sit within the curve
of the lateral ventricles extending to
the ventricles
Lateral wall of frontal horn and
central horn lateral ventricle is
adjascent to caudate
nucleus/germinal matrix
Thalamus
Pituitary gland
Infundibulum
Septum pellucidum
36
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
Corpus callosum
Septum pellucidum
Cavum septum
pellucidum
37
3/1/2013
Indonesian Pediatric Society
Head ultrasound and Neonatology Working Group
Echocardiography in Neonate Cardiology Working Group
Pediatric Imaging Working Group
38
