Sonographic stroke templates

Abstract

This chapter provides arterial and venous stroke templates, designed with neonatal brain ultrasound as the viewpoint and adult stroke templates as the basis. Images change with maturation of the stages of infarction: swelling, necrosis, organisation and tissue loss. Adult templates permit recognition of well-delineated stroke types observed in the newborn brain. All circle of Willis arteries can be involved, as can their perforator branches. Middle cerebral artery (MCA) truncal stroke (anterior or posterior) is an important entity, with different prognosis than complete MCA stroke. Knowledge of these templates also aids in the definition of combinations of infarction (e.g. internal carotid artery stroke or pial plus perforator stroke) and of interarterial watershed injury. Venous templates, even if still under development around the time of birth, permit us to understand brain injury associated with sinus or deep vein thrombosis, especially several types of intracranial haemorrhage. Hindbrain stroke templates are scarcely applied to perinatal lesions.