Pediatric Clinic of the Social Foundation of Bamberg, Bamberg, Germany.
Ultraschall Med. 2018 Apr;39(2):132-152. doi: 10.1055/a-0571-8552. Epub 2018 Mar 13.
Prenatal, neonatal meningoencephalitis and infections of the brain in older infants are often associated with serious complications which can be diagnosed by sonography through the open fontanelles. Most frequently postmeningitic hydrocephalus and subdural effusions occur. Rarer complications are brain abscesses and ventriculitis which are caused by gram negative bacteria such as E. coli, Serratia marcescens, Proteus and Enterobacter. A serious complication after ventriculitis is the development of compartment hydrocephalus. Multifocal small echogenic lesions scattered all over the brain are suspicious of fungal infections. Stripe-like echogenicities in the basal ganglia of newborns are typical for prenatal infections such as infections with cytomegalovirus, rubella, herpes, toxoplasma gondii and HIV. Late sequelae are intracranial cysts, multifocal encephalomalacia and intracranial calcifications. Color Doppler shows increased perfusion of the brain in the acute phase of the disease. Brain abscesses and infarcts are characterized by decreased or missing perfusion. Spectral Doppler shows increased flow velocities. Increased intracranial pressure causes an increase of the flow velocities in the intracranial part of the internal carotid artery in comparison with the extracranial part. All complications can be diagnosed by ultrasound. Other imaging methods such as MRI are only occasionally necessary.
产前、新生儿脑膜脑炎和较大婴儿的脑部感染常伴有严重并发症，这些并发症可通过囟门未闭的头颅超声进行诊断。最常见的是脑膜炎后脑积水和硬膜下积液。较少见的并发症是脑脓肿和脑室炎，这些并发症是由革兰氏阴性细菌引起的，如大肠杆菌、粘质沙雷氏菌、变形杆菌和肠杆菌。脑室炎后的一个严重并发症是间隔性脑积水的发展。脑内弥漫分布的多发性小回声病灶提示真菌感染。新生儿基底节条纹状回声增强提示产前感染，如巨细胞病毒、风疹、疱疹、弓形体病和 HIV 感染。晚期后遗症包括颅内囊肿、多灶性脑软化和颅内钙化。彩色多普勒在疾病急性期显示脑灌注增加。脑脓肿和梗死的特点是灌注减少或缺失。频谱多普勒显示血流速度增加。颅内压增高导致颈内动脉颅内段的血流速度比颅外段增加。所有并发症均可通过超声诊断。其他成像方法，如 MRI，仅在偶尔需要时使用。
