Through the anterior fontanelle

I took some cool pictures today - using an ultrasound scanner. Too bad they had to remain in the patient's notes! Premature babies' brains are slightly different in structure to term babies' brains. In particular, they are more prone to bleeding into them, so the babies on the Unit often need cranial ultrasounds. The fact that babies' skull bones are not yet fused means it is possible, by holding the probe over the largest gap between the bones (i.e. the anterior fontanelle), to get an ultrasound image of the brain. Occasionally one finds unexpected malformations of the brain, such as this example (I only have a picture because I presented this case at Thursday's perinatal morbidity meeting):


Even with this poor quality image, it is possible to discern that the lateral ventricles are fused. This is known as holoprosencephaly. In its most extreme form, this results in cyclopia, seen here in a kitten. The baby whose brain is seen in these ultrasound images weighs a mere 480g and was born at 24 weeks' gestation.