If a child continues to miss critical milestones or fails to hit them within an appropriate developmental timeline, your pediatrician may refer you to a pediatric neurologist. These doctors specialize in diseases affecting infants and children’s nervous systems. They will begin the diagnostic process by conducting various neurological tests such as cranial ultrasound to help determine if a child has a brain injury that has led to cerebral palsy.

What Is a Cranial Ultrasound?

A cranial ultrasound captures images of brain waves via high-frequency sound. Cranial ultrasounds are preferred imaging tests because they are painless and usually faster than MRIs, and thus suitable for newborns. However, they may not provide the same level of imaging results as MRIs can.

When Can a Cranial Ultrasound Be Performed?

Cranial ultrasounds are typically done on babies to check for any problems that may arise from premature birth or other birth complications. Ultrasound waves aren’t able to pass through bones, so ultrasounds checking the brain can’t be done once the bones of the cranium (skull) have fused together. Typically, cranial ultrasounds can be used to observe the ventricles and other problems with the brain in babies up to around 18 months old.

Why Your Doctor May Order a Cranial Ultrasound

Some pediatricians express concerns about brain injury before, during, or immediately after birth due to specific risk factors. There are several circumstances and situations that may put a baby at an increased risk of cerebral palsy, including pregnancy complications, maternal health issues, and infant illnesses.

For instance, If either the baby or mother contracts a serious infection such as syphilis or bacterial meningitis, the baby may become more susceptible to cerebral palsy because of possible brain trauma. Premature babies are also at a higher risk for developing cerebral palsy, especially if they develop jaundice that’s left untreated. Similarly, if the baby was born in distress or needing immediate resuscitation, the pediatrician may be concerned about possible brain injury from lack of oxygen before delivery.

If your pediatrician has concerns about your child being at risk for cerebral palsy, there are several screenings and tests they can perform to solidify an accurate diagnosis. One part of the diagnosing process is imaging tests that allow medical professionals to view a child’s brain for any abnormalities.

When physicians want a quick look at brain tissue to confirm a cerebral palsy diagnosis or suspect brain injury before, during, or after childbirth, they may use a cranial ultrasound.

How Doctors Perform Cranial Ultrasounds

Ideally, it’s best to perform a cranial ultrasound when the baby is calm and relaxed or asleep. An ultrasound technician applies a water-based gel to the baby’s head on top of the anterior fontanelle. This aids conduction of the ultrasound waves. The technician then uses an ultrasound probe to carefully move around the head so they can examine the infant’s brain and view the images on a screen. They will then record images as necessary.

While the anterior fontanelle is the most common acoustic window for a cranial ultrasound, more advanced technicians may also get additional views. The posterior fontanelle, temporal window, or the mastoid fontanelle are especially helpful views for posterior fossa structures.

Standard cranial ultrasounds typically involve recording around 10 views from various angles of the brain, including five in the parasagittal or sagittal planes and five in the coronal plane. This lets a radiologist view most parts of the brain and all parts of the ventricles.

Risks vs. Benefits of a Cranial Ultrasound

Most medical procedures carry some level of risk with them. However, standard diagnostic ultrasound, including cranial ultrasounds, have no known harmful effects on humans. Cranial ultrasounds do offer several benefits, though. It’s important to talk with a trusted pediatrician about these beforehand and take an opportunity to address any other questions or concerns you may have.

Here are some of the benefits of cranial ultrasounds:

• The procedure is noninvasive, meaning no injections or needles.
• Sometimes ultrasound exams can be temporarily uncomfortable, but it should never be painful.
• Cranial ultrasound is widely available, less expensive than many other types of imaging methods, and easy-to-use.
• Cranial ultrasound imaging is very safe and doesn’t use any radiation.
• Cranial ultrasounds provide clear pictures of soft tissues that typically don’t show up well on x-ray imaging.

Cranial Ultrasound Limitations

Overall, cranial ultrasounds are less invasive and provide reliable results to specialists. However, there are some limitations that are important to mention. A cranial ultrasound is extremely sensitive to motion, so a crying or overly active baby can slow the examination process down.

Cranial ultrasound results can also be altered due to:

• Changes in blood flow patterns resulting from irregular heart rhythms or heart disease
• A recent surgical incision or open wound near the area being imaged

It’s normal for parents to wonder, “Can cranial ultrasound detect cerebral palsy?” It’s also important to realize the role cranial ultrasound has in the detection of brain injury can vary from case to case. In some cases a CT or MRI may be the preferred imaging modality. It’s best to continue to work with pediatricians and specialists you have come to know and trust.

Did a birth injury or medical error result in your child’s cerebral palsy diagnosis? Complete our online form today and let the Cerebral Palsy Family Lawyers at Janet, Janet & Suggs, LLC review your case to schedule a free, no-obligation consultation.

Reviewed by:
Trish Fletcher, MS, BSN, CRNP, NNP-BC, ALNC
Neonatal Nurse Practitioner | Birth Injury Legal Nurse Consultant

Tricia is a dedicated, focused, Birth Injury Legal Nurse Consultant and Neonatal Nurse Practitioner with more than 25 years of experience. Her strong clinical and critical thinking skills, paired with expertise caring for neonates in a Level III Neonatal Intensive Care Unit (NICU), ensures meticulous medical records review. READ FULL BIO

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