Cranial ultrasound in neonatal brain infections.
Roosmarijn G Licht-van der Stap, Linda S de Vries, Ana Alarcon and 2 others
PMID 39996578WHAT IT FOUND
Cranial ultrasound should be done early and serially in suspected neonatal meningitis because lesions evolve.
Pathogen-specific patterns and timing guide follow-up, and MRI is recommended for complicated cases or abnormal ultrasound.
Key findings
01Early cranial ultrasound at admission and serial scanning are recommended because neonatal brain lesions evolve over time.
02Group B Streptococcus meningitis can show stroke-like lesions that are often subtle early and become more distinct after 48 to 72 hours.
03E. coli meningitis has a high risk of ventricular dilatation, which can develop weeks after treatment, so follow-up ultrasound and head circumference are advised until at least 8 weeks after onset.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
This is a narrative review, not a systematic review, so the search was not rigorous and relevant studies may have been missed. No randomized clinical trials were found, so the review does not show that ultrasound or MRI changes outcomes. Much of the content is based on case reports, textbook chapters, and expert description rather than controlled study data. The paper describes imaging patterns, not treatment effects, so it cannot tell a therapist which intervention works. Recommendations such as serial ultrasound and MRI are expert guidance, not tested interventions.
The easy way to misread this
Do not read a normal cranial ultrasound as ruling out brain injury. Small cortical lesions can be missed, and the review recommends at least one MRI when meningitis is complicated or ultrasound findings are abnormal.