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Central nervous system
Published in A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha, Clark’s Procedures in Diagnostic Imaging: A System-Based Approach, 2020
A Stewart Whitley, Jan Dodgeon, Angela Meadows, Jane Cullingworth, Ken Holmes, Marcus Jackson, Graham Hoadley, Randeep Kumar Kulshrestha
Cerebral ultrasound through the patent anterior fontanelle is an important diagnostic tool in the neonate for detection of peri-natal haemorrhage and hydrocephalus, and rare congenital abnormalities and space-occupying lesions (SOLs). In experienced hands it is a quick, safe, and accurate tool, whereas in this age group CT and MRI is more complicated, often involving the additional risk of sedation. The anterior fontanelle usually closes by 2 years of age with a median time of around 14 months, after which it can no longer be used as a portal for ultrasound.
Neuroimaging
Published in Sarah McWilliams, Practical Radiological Anatomy, 2011
o Use the anterior fontanelle, which closes at 18 months, or the posterior fontanelle, which closes at 3 months. The probe must have a small foot to fit the small size of the anterior fontanelle and a wide curvilinear array to cover the brain inside (Fig. 1.61).
Medical devices and the pediatric population – a head-to-toe approach
Published in Expert Review of Medical Devices, 2019
Joy H. Samuels-Reid, Judith U. Cope
The head is large relative to the body in infants and young children. The skull is thinner and more flexible. This requires different types of considerations for the pediatric population and age-appropriate medical devices. Head circumference is a significant metric in assessing growth and development of the neonate and infant and is measured across the frontal-occipital prominence, the area of greatest diameter. While head circumference is an indicator for growth and development in the pediatric population, it is not in adults. It is tracked on growth charts during pediatric exams from birth through the first few years. Newborns have greater brain weights in proportion to body weight. The anterior and posterior fontanelles close at different times: the anterior fontanelle is the last to close between 1 to 3 years (the median time is about 13.8 months) and the posterior closes 2–3 months after birth. Depressed fontanelles may indicate dehydration, while bulging fontanelles may indicate swelling in the brain [6]. Early closure of fontanelles may lead to microcephaly, misshapen head and delay in closure may signal hydrocephalus. Cranial sutures close at different rates. It is important that use of devices take into consideration the status of cranial sutures and the stage of growth and development of the skull. If sutures close prematurely, they result in craniosynostosis [7]. Devices such as cranial helmets are often used to correct positional head deformity such as plagiocephaly.