Neonatal Cranial Ultrasound Guidelines

Indications for cranial ultrasound

Criteria for repeat ultrasound

Indications for cranial ultrasound: 

1. VLBW infants (ie babies < 1.5kg) in the first week after birth 
2. Suspected severe intracranial haemorrhage 
3. HIE stage 2/3 
4. Neonatal convulsions 
5. Antenatal diagnosis of brain malformations 
6. Suspected congenital infections (TORCH), meningitis, septicaemia (especially candida and gram negative) 
7. Micro/macrocephaly or suspected hydrocephaly 
8. Metabolic, neurological, coagulation abnormalities 
9. Dysmorphic infants with involvement of CNS or midline defects such as hypertelorism (to identify structural abnormalities) 

Criteria for repeat ultrasound (to be decided by ward consultant or person performing initial scans: 

1. Suspected hydrocephalus (H/C increasing >1cm/week) 
2. Abnormal earlier scan (marked/dense OP flares/PVL, hydrocephalus, unusual or unexpected findings, Grade 3 or 4 IVH (grade 1 and 2 do not need routine F/U U/S unless clinical concern exists eg rapidly increasing head circumference). 

Note: Please plot all admitted babies’ head circumference at admission and weekly thereafter.