Subependymal cysts in the newborn: transfontanel ultrasound and CT study

Transfontanel ultrasound is generally used as an initial diagnostic method to rule out intracranial pathology in the newborn (NB). Given its sensitivity in the detection or brain lesions and its versatility, allowing sagittal and coronal sections, it is the method of choice for studying the brain of the NB. We present a series of 30 transfontanel ultrasound studies done in 30 NB within 72 hours of birth. The aim was to study lesions of the germinal matrix, which is highly vulnerable to different pathogens in this early period of life; we focus particularly on the existence of Subependymal cysts (SEC) and we attempt to discern the possible relationship between said lesions and the patient's clinical situation. For this purpose, we employed 5 and 7.5 Mhz transducers, after which computerized tomography (CT) was performed in those who presented any type of lesion in ultrasound images. Of the 30 ultrasound studies, 24 showed normal brains and six presented some type of lesions: 3 cases of germinal matrix hemorrhage in preterm NB, One case of ventricular asymmetry of unknown cause and two cases of unilateral SEC in full-term NW who presented no risk factors. CT confirmed ultrasound findings of a cystic lesion in one of these cases. We have found no previous reports of detection of these lesions by CT,SEC are associated with different etiologic agents, but they probably can exist despite the absence of an evident cause and in no way jeopardize the child's neurological development. (Author)