Making use of the mastoid fontanelle: Additional views in neonatal intracranial ultrasound imaging

Sophie McGlade1, Peter Cantin2, Judith Foster2, 1Peninsula Radiology Academy, 2Radiology Plymouth University Hospital Trust


Ultrasound is widely used for examination of the brain in neonates. It has particular value for screening and follow-up in those at high risk of intracerebral haemorrhage, for detection of ischaemic or haemorrhagic brain injury as well detection of structural abnormalities or conditions such as hydrocephalus.

Routine intracranial ultrasound examination takes advantage of the anterior fontanelle prior to its ossification at around 6-9 months of age in normality. Sagittal and coronal images from this acoustic window are usually obtained, however, views of the infratentorial posterior fossa structures such as the cerebellum may be limited. Thus alternative acoustic windows such as the posterior fontanelle or mastoid fontanelle may need to be used.

This poster focuses on the use of the mastoid fontanelle, which has particular value in detecting haemorrhage involving the cerebellum, brainstem and subarachnoid cisterns. Views through the mastoid fontanelle are not universally obtained as part of a standard examination and this poster aims to highlight particular benefits of incorporating this approach, describe good sonographic technique, demonstrate anatomical structures which may be appreciated on a normal study, and introduce common or important pathological appearances where this approach has been utilised

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