Neurosonography (NSG) in infants

Neurosonography (NSG) is an ultrasound of a baby's brain done through the anterior fontanelle, the soft spot on top of the head where the skull bones have not fused yet. Sound waves pass through it freely. The doctor sees the ventricles, choroid plexus, grooves of the brain, midline structures and membranes. There is no radiation and no anesthesia. The scan takes 10-15 minutes.

At Oberig Clinic, ultrasound doctors of the Diagnostic Department do this scan. They work with babies every day. You get the report right after the exam, and the doctor explains it in plain words. If needed, you can see a pediatric neurologist or pediatrician the same day.

What neurosonography shows

The doctor measures the lateral, third and fourth ventricles, the gap between the hemispheres and the space around the brain. They check symmetry, the choroid plexus and the periventricular areas, the tissue around the ventricles. Doppler mode shows blood flow in the main brain arteries.

Doppler matters most after a hard birth or low oxygen. The doctor measures flow speed and the resistance index, which tells how much the vessels resist blood flow. These numbers show if the brain gets enough oxygen. They also help track change over time.

The scan helps to catch enlarged ventricles and hydrocephalus early. It also finds bleeds, cysts, signs of hypoxic-ischemic injury, periventricular leukomalacia and birth defects of the brain. Some findings need no treatment. Small choroid plexus cysts, for example, usually disappear on their own within months. Others need a neurologist and a repeat scan.

Know the limits. Ultrasound sees the outer cortex, the back of the skull and tiny changes poorly. If questions remain, the doctor orders a brain MRI. NSG does not replace a neurologist's exam. It adds to it and shows what is going on inside.

NSG, MRI or CT: which one?

For a baby with an open fontanelle, neurosonography comes first. No prep, no sedation, and you can repeat it as often as needed. CT uses radiation, so children get it only in emergencies, such as a head injury. MRI shows the brain in more detail. But your baby has to lie still for 20-40 minutes, and that often means medication-induced sleep.

So in real life everything starts with ultrasound. If it shows changes that need a closer look, or the fontanelle is almost closed, the neurologist sends you for MRI. The NSG results still count. They show how the brain changed from the first weeks.

Who needs it and when

Many maternity hospitals scan at-risk newborns before discharge. A routine scan is often done at 1 month, together with a hip and abdominal ultrasound. Your pediatrician or neurologist may order an extra scan if something worries them.

Main reasons:

• premature birth, low birth weight, C-section, a very fast or difficult delivery
• lack of oxygen at birth, a low Apgar score, a stay in intensive care
• infections before birth, Rh conflict, genetic syndromes
• a fast-growing head, a bulging or sunken fontanelle, an uneven head shape
• seizures, trembling chin or hands, constant head arching, too much sleepiness or irritability
• frequent forceful spitting up, delays in motor skills

If a neurologist already follows your baby, the scan is repeated on their schedule. This shows whether the ventricles change and whether cysts shrink.

Premature babies: a special schedule

Babies born before 32-34 weeks have fragile vessels around the ventricles. Bleeds and periventricular leukomalacia happen much more often in them than in full-term babies. The first scan is done in the neonatal unit. After discharge, scans continue on the plan of the neonatologist and neurologist.

Normal values for preemies use corrected age, counted from the due date, not the birth date. Say your baby is 3 months old but was born 8 weeks early. The doctor reads the scan as for a 1-month-old. Tell the doctor the gestational age at the start. The report depends on it.

Regular scans are most useful in the first months. Some changes, like the cystic form of leukomalacia, show up 2-4 weeks after birth, not right away. Finding them early means rehab can start while the brain is most flexible.

Preparing your baby and how the scan goes

No special prep. The best time is when your baby is fed and sleepy. A calm baby lies still, and the scan goes faster. Bring a bottle, a pacifier, a diaper and a favorite toy. If your baby has had a head ultrasound before, bring the old reports so the doctor can compare.

Your baby lies on the couch or in your arms. The doctor puts warm gel on the fontanelle and places the probe lightly. No pressure on the head. The probe is tilted at different angles to get slices in two planes. If the back fontanelle is still open, the doctor looks through it too, and checks the back of the brain through the temple. It doesn't hurt. Many babies fall asleep during the scan.

Plan about half an hour for the whole visit, including registration, undressing and a feed if your baby gets hungry, because a relaxed baby gives the doctor clearer images and a shorter scan. Parents stay in the room the whole time. You can talk to your baby, stroke the hands, sing. It helps.

A referral may say "NSG", "neurosonography" or "brain ultrasound". It is the same test. You don't need to book anything extra.

Normal values in infants

Normal values depend on age, gestational age and even probe position. The table gives only general guide values for the first year. The doctor makes the final call, taking into account head size, neurological status and earlier scans.

Measure	Guide value
Frontal horns of lateral ventricles (depth)	up to 3-4 mm
Bodies of lateral ventricles	up to 4 mm
Third ventricle	up to 4-5 mm
Interhemispheric fissure	up to 3-4 mm
Subarachnoid space	up to 3 mm
Cisterna magna	up to 10 mm
Choroid plexus	even, symmetrical, no cysts
Midline structures	no shift

Don't compare numbers from different reports on your own: clinics may measure ventricles in slightly different planes, and a 1 mm gap between two reports can mean nothing at all. A small deviation in one value without symptoms is often a normal variant. A combination is what raises concern: wide ventricles that keep growing, a bulging fontanelle, a head that grows faster than it should.

Reading the report

The report describes each structure and ends with a conclusion. Here is what parents see most often and what it means.

Choroid plexus cysts and subependymal cysts are small fluid-filled spaces. Usually they are left over from development before birth. They don't affect the brain and disappear by 6-12 months. The doctor just notes their size.

Wide ventricles (ventriculomegaly) can be mild and stable. Then the doctor simply watches them. If the ventricles grow, it is called hydrocephalus. Your baby needs a neurologist, sometimes a neurosurgeon.

Bleeds inside the ventricles happen more often in premature babies. They are graded from I to IV. A grade I bleed usually clears without consequences. Higher grades need close follow-up.

Brighter periventricular areas may point to past oxygen shortage. The doctor checks this against how your baby behaves and always repeats the scan. Take the report to a pediatric neurologist. The neurologist decides if your baby needs treatment, massage or just follow-up.

Follow-up scans: when to repeat

A repeat scan is needed when the first one found cysts, wide ventricles, signs of a bleed or oxygen shortage. The usual gap is 1-3 months, shorter for bleeds or fast-growing ventricles. Do follow-up scans in one clinic. The doctor then compares images made the same way and sees real change, not the difference between machines. If the first scan was normal and your baby is fine, you don't need to repeat it without a doctor's order.

Frequently asked questions

Up to what age can it be done?

While the anterior fontanelle is open, usually up to 12-18 months. The smaller it gets, the less the doctor sees. Older children get an MRI if needed.

Is ultrasound safe for a baby's brain?

Yes. There is no radiation, and the probe power for babies is minimal. You can repeat the scan as often as needed.

Should I cut or wash my baby's hair first?

No. Hair doesn't block the ultrasound. The gel wipes off easily. Take the hat off in advance.

Can the scan be done if my baby cries?

Yes, but crying and moving get in the way. Feed your baby before the scan or give a pacifier.

Do I need a referral?

No, you can book on your own. With a referral, though, the doctor knows what to focus on.

The report mentions a cyst. What now?

Don't panic. Most choroid plexus cysts are harmless. Show the report to a neurologist and come for the follow-up scan on time.

Price at Oberig Clinic

The price depends on who does the scan and on its scope. You can pair NSG with a hip ultrasound by the Graf method. The price list has a combined option, and your baby is checked in one visit. A scan by an Honored Doctor of Ukraine costs a little more.

Test	Price
Neurosonography (NSG)	UAH 1,065
NSG by Honored Doctor of Ukraine N. Riepina	UAH 1,260
Combined pediatric ultrasound (NSG and hips by Graf)	UAH 1,395
Combined pediatric ultrasound by N. Riepina	UAH 1,425
Pediatric neurologist consultation, PhD	UAH 1,790

Prices follow the clinic price list as of 18.10.2026. They may change, so please check the current price with our contact center.

Why choose Oberig Clinic

• 17 ultrasound machines, 7 of them expert class, with probes for babies and Doppler modes.
• Scans are done by Nataliia Riepina, Honored Doctor of Ukraine and member of the European Federation of Societies for Ultrasound in Medicine and Biology (EFSUMB), and by Halyna Huivan, a top-category ultrasound doctor who examines children.
• You get the report right after the scan, explained for parents, and it can be compared with earlier scans done here.
• Pediatric neurologists, pediatricians, orthopedists and neurosurgeons work in one clinic. See other children's scans on the ultrasound for children page.

Address: 3 Zoolohichna St., buildings G and V, Kyiv. Book online at https://my.oberig.ua/ua/appointment/ or call +38 044 521 30 03.