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Over a mere 5 years, neonatal cranial sonography has evolved from
an obscure and largely experimental imaging possibility to the
modality of preference in the examination of the young brain. The
almost immediate acceptance of the ultrasound examination of the
neonatal brain was based on a number of coinci dent factors, the
most important of which was the emergence of a burgeoning
population of premature neonates who were, for the first time,
surviving be yond infancy. These delicate patients were beginning
to withstand the rigors of extrauterine life when not fully
prepared for it; pulmonary, cardiac, and infec tious diseases no
longer claimed most of them. With survival, a new specter reared
its head: Would the eventual mental and neurologic status of these
same children be worth the expense and time needed to bring them
through their first months? This issue became increasingly pressing
as evidence mounted through the 1970s that very premature neonates
were at a high risk for intracranial hemor rhage and
posthemorrhagic complications. An imaging modality that could
evaluate the premature brain was sorely needed. The CT scanner with
its proven ability to diagnose intracranial hemorrhage was of
little value in this regard. So too were static gray-scale or
waterpath ultrasound units. These modalities all had the same
limitation, lack of portability. As neonatal intensive care units
proliferated, so did the technology that would soon allow cribside
neonatal neuroimaging, the real-time sector scanner."
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