Ultrasound and CT of the posterior fossa in neonates

Ultrasound, CT and MRI may all be used in the evaluation of the posterior fossa in neonates depending on the clinical scenario. Ultrasonography is particularly valuable for the evaluation of the neonatal brain because of the lack of ionizing radiation and the ability to perform exams at the bedside and, importantly, advancements in ultrasound technology now allow for diagnostic-quality imaging. While CT is still the initial imaging modality of choice in most neurologic emergencies, in the neonate, ultrasound is the first line in nontraumatic emergencies. The goal of this chapter is to discuss the ultrasound technique for evaluation of the cerebellum, to describe the normal sonographic and CT appearance of posterior fossa and to provide the classical findings of the most common cerebellar abnormalities. While ultrasound is able to accurately diagnosis a majority of cerebellar abnormalities in neonates, subsequent MR imaging remains essential to confirm findings and to detect associated abnormalities.