Looking inside the heads of prems …

Cranial ultrasound is a bit last century. It's a good displacement activity for restless registrars but the information it yields on premature babies seldom helps management, rarely discovers a treatable disease, and commonly creates significant (but often unjustified) anxiety among parents. It has notoriously poor sensitivity for ascertaining acute ischaemic damage. If it suddenly went, would we really miss it? Or so I thought until I read the paper from Horsch et al, who compared cranial ultrasound with MRI for the detection of grey and white matter damage. Crucially, they used both techniques at 40 weeks post menstrual age, and the surprising finding is that at this time they performed very similarly. From which I deduce that one of the fundamental problems of cranial ultrasound is not that the mode of …