In which cases is transcranial ultrasound indicated for infants and adults?

The article was professionally consulted by Specialist Doctor I Tran Cong Trinh - Radiologist - Radiology Department - Vinmec Central Park International General Hospital. The doctor has many years of experience in the field of diagnostic imaging.
Transcranial ultrasound is a modern imaging method with important implications in the diagnosis and detection of brain abnormalities in infants and adults. However, there will be many people who hear about this procedure and do not know when it will be prescribed by a doctor. The following article will help you answer the question "In what cases is transcranial ultrasound indicated for infants and adults?"

1. What is Transcranial Ultrasound?

Transcranial ultrasound is a technique that uses reflected sound waves to capture images of the skull and the inner fluid chambers through which cerebrospinal fluid (CSF) flows.
Transcranial ultrasound can be performed in both children and adults. In children, this method is indicated to be used quite a lot for the purpose of assessing complications that occur in preterm birth. Transcranial ultrasound is also done to evaluate problems in the skull and ventricles in children as young as 18 months of age. In adults, transcranial ultrasound is performed to obtain a visual image of the brain mass during cranial surgery.
Human bones can block ultrasound waves, making it impossible to pass through, so ultrasound to evaluate the skull is not done after the skull bones (cranium) have grown to fuse together. Therefore, transcranial ultrasound performed in children will take place before the skull has grown and in adults after the skull has been opened during surgery.
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2. In which cases is transcranial ultrasound indicated?

2.1. Complications in premature babies detected by transcranial ultrasound

As mentioned above, in children, transcranial ultrasound is used by doctors to evaluate complications that occur during preterm birth. Complications of preterm birth include:
White matter brain damage (or ischemic brain damage - PVL): this is a condition in which tissue around the ventricles is damaged, possibly due to a lack of oxygen and blood volume. Circulation to the brain is impeded during and after childbirth. Intraventricular hemorrhage (IVH): is a phenomenon secondary to intracerebral hemorrhage or cerebral parenchymal bleeding into the ventricular cavity. Cerebral white matter lesions (PLV) and visible intracerebral hemorrhage (IVH) are both very dangerous diseases. They will increase the risk of children having birth defects, which can slightly affect a child's ability to learn or develop, more seriously, can cause brain paralysis or intellectual disability in children.
Brain white matter (PLV) lesions can take several weeks to detect. Therefore, from 4-8 weeks after birth, transcranial ultrasound technique needs to be repeated many times if this lesion is detected in the baby's brain.
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In contrast, intraventricular hemorrhage (IVH) is easier to detect than leukoencephalopathy (PLV), usually within the first week of life through transcranial ultrasound. The reason it can be detected more quickly is that when it occurs, intraventricular hemorrhage develops during the first 3-4 days after birth. This type of lesion is more common in premature babies than in term babies.
Besides, this transcranial ultrasound technique is also performed by doctors to assess head size. At the same time, it also helps detect inflammation in or around the skull, skull problems that will be screened from birth (may include congenital hydrocephalus).

2.2. When is transcranial ultrasound indicated in neonates?

In newborns, transcranial ultrasound will be ordered by the doctor when:
Want to detect bleeding in brain tissue or ventricles (IVH). Want to detect birth defects. To locate an infection or tumor. Want to evaluate hydrocephalus, or enlarged ventricles. In addition, transcranial ultrasound is used to detect any damage to the white matter around the ventricles. This phenomenon is the white matter lesion (PVL) mentioned above.
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3. In what cases is transcranial ultrasound in adults performed?

Transcranial ultrasound in adults is much more difficult than in infants, because by the time of maturation, the skull bones have fully developed, but ultrasound waves cannot penetrate human bones. Therefore, transcranial ultrasound will only be performed when the skull has opened up during brain surgery. This technique is indicated by doctors to use in adults in case they want to measure the patient's brain volume, in order to support safe resection.
In addition, transcranial ultrasound is used to assess stroke risk in adults and children with sickle cell disease. Besides, it is also used to evaluate disorders affecting blood flow inside the brain.
Hopefully, through the information shared in the article, readers have got the answer to the question "In what cases is transcranial ultrasound indicated for infants and adults?", as well as Add useful medical knowledge around transcranial ultrasound technique.
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Transcranial ultrasound is a diagnostic method with high accuracy in diagnosing complications occurring in premature babies, especially dangerous diseases such as brain white matter lesions (PVL) and intraventricular hemorrhage. (IVH). Besides, it is also an effective tool to help doctors measure brain volume for cranial surgery in adults. Accordingly, to achieve the most accurate results, you should choose addresses with quality standard ultrasound systems, professional and specialized doctors.
Currently, Vinmec International General Hospital has been using modern generations of color ultrasound machines. One of them is GE Healthcarecar's Logig E9 ultrasound machine with full options, HD resolution probes for clear images, accurate assessment of lesions. In addition, a team of experienced doctors and nurses will greatly assist in the diagnosis and early detection of abnormal signs in order to provide timely treatment.

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