Sonographic Measurement of Brainstem Through the Foramen Magnum in Premature Neonates Can Predict Neurodevelopment Outcome?

Background: To investigate whether serial morphometric measurements of the brainstem using high resolution trans-foramen-magnum ultrasound (US) in premature neonates correlate with neurological outcomes.Methods: Serial brain ultrasound scans were performed in 36 consecutive preterm infants born at <34 weeks of gestation from birth until term-equivalent age. Two-dimensional brainstem measurements of the pons and medulla oblongata were compared with those in a cohort of 67 healthy full-term newborns. Neurologic assessment of the premature infants was assessed at 5 years of age.Results: Of the 36 preterm infants born between 25 and 34 weeks of gestation, eight had significantly delayed growth profiles in both the pons and medulla and developed neurological sequelae by 5 years of age.Conclusions: Morphometric measurements of the developing brainstem using high resolution trans-foramen-magnum ultrasound (US) may help predict neurological outcome in high-risk neonates, particularly in those who are born extremely premature.

Generative Adversarial Networks to Improve Fetal Brain Fine-Grained Plane Classification

Generative adversarial networks (GANs) have been recently applied to medical imaging on different modalities (MRI, CT, X-ray, etc). However there are not many applications on ultrasound modality as a data augmentation technique applied to downstream classification tasks. This study aims to explore and evaluate the generation of synthetic ultrasound fetal brain images via GANs and apply them to improve fetal brain ultrasound plane classification. State of the art GANs stylegan2-ada were applied to fetal brain image generation and GAN-based data augmentation classifiers were compared with baseline classifiers. Our experimental results show that using data generated by both GANs and classical augmentation strategies allows for increasing the accuracy and area under the curve score.

Idiopathic Dural Optic Nerve Sheath Calcification Associated with Sclerochoroidal Calcification: Case Report and Review of Literatures

We present a patient with idiopathic intracranial calcifications with simultaneous involvement of sclera, choroid, optic nerve, and trochlear apparatus. A 70-year-old woman with bilateral decreased vision was referred to our hospital. Ocular examinations revealed sclerochoroidal mass beneath superotemporal vascular arcade in macular area. Orbital CT scan shows bilateral calcification of dural optic nerve sheath and posterior wall of the globe as well as calcification in the trochlear apparatus and brain. Ultrasound showed highly reflective echogenic lesion with shadowing. OCT revealed rolling topography with thinning of the overlying choroid and outer nuclear layer as well as absence of the external limiting membrane and inner segment-outer segment junction. Slight irregular thickening of the retinal pigment epithelium is present. It is the first case of simultaneous bilateral dural optic nerve sheath and sclerochoroidal calcification.

Point of care B mode ultrasound in Neurological Emergencies

Bedside ultrasound allows diagnostic, therapeutic and monitoring approaches in critically ill patients. Currently ultrasound enables to perform a scan almost of all body regions in both adult and pediatric populations. Head and especially central nervous system, have traditionally been excluded, based on the idea that access to the brain is not possible given the limitation of the skull, Therefore in adults, the main ultrasound applications in central nervous system assessment have been limited to the transcranial Doppler and the measurement of the optic nerve sheath as a subrogate finding of intracranial hypertension. Nonetheless, through the temporal bone window it is possible to visualize the midline (third ventricle), nuclei basal ganglia, the mesencephalon and the lateral ventricles: the basic structures for the brain ultrasound Although the Gold standard for the initial assessment of many neurological pathologies in the emergency department is computed tomography; the ultrasonography allows an approximation to the midline shift and acute bleeding, combined with transcranial doppler some hemodynamics estimations can be acceded, this allow the diagnosis or follow-up of increased intracranial pressure which could favor pharmacological treatments and follow the therapeutic effect. In this review, basic B mode neurosonology for the emergency physician is explored and future directions discussed.