A specular reflection arising from the ventricular wall: a potential pitfall in the diagnosis of germinal matrix hemorrhage.

Reflection artifacts may complicate the diagnosis of intracranial hemorrhage in preterm neonates. A linear focus of bright echoes in the region of the germinal matrix at or anterior to the caudothalamic grooves, often seen on parasagittal scans, may be mistaken for a germinal matrix hemorrhage but is actually a reflection of the ultrasound beam at the wall of the lateral ventricle. Cranial sonograms of 100 preterm infants were retrospectively analyzed and categorized with regard to presence and size of specular reflection. Eight cases demonstrated a bright echogenic focus; seven of these potentially could have been mistaken for hemorrhages.