Ventriculitis in the neonate: recognition by sonography

Abstract

In the neonate, ventriculitis and inflammatory infiltration of the choroid plexus usually accompany meningitis. Intracranial sonograms were reviewed from six infants referred for evaluation because of clinically suspected or confirmed ventriculitis. Findings included ventricular dilatation with irregularity of the ventricular margins and increased periventricular echogenicity. The choroid plexus margins also appeared poorly defined with loss of the normally smooth contour. Echogenic material was seen within the lateral ventricles, and intraventricular septa formation resulted in ventricular compartmentalization. Parenchymal changes included periventricular cavitation and a diffuse increase in cortical echogenicity. The ventricular pathology was more apparent on sonograms than on computed tomographic scans obtained at comparable times. In particular, sonography better demonstrated the ventricular compartmentalization from intraventricular septum formation. Identification of such partial ventricular isolation is especially important when treatment involves intraventricular shunt placement or the administration of intraventricular antibiotics. This experience suggests sonography should be the initial imaging method for evaluating ventriculitis and its complications in the newborn.