Head Ultrasound in Term Infants: Easily missed sonographic findings

Neonatal encephalopathy (NE) findings, particularly hypoxic-ischemic injury, are often evident on magnetic resonance imaging (MRI). While MRI is widely used and accepted for NE evaluation, it is expensive and not always accessible for critically ill newborns. Consequently, head sonography (US) remains the preferred initial imaging method for assessing the brain in NE neonates. In fact, NE may be initially suspected or diagnosed using head US. US is noninvasive, affordable, and portable, allowing for convenient examinations without moving the infant. However, some subtle signs of NE on US can be easily missed, leading to delayed or incorrect diagnosis. The goal of this lecture to review the range of US findings in NE, particularly those that may be easily overlooked. Recognizing these findings could potentially enhance detection rates, reduce errors, and improve patient care.