2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
2024 State of Marketing Report – by HubspotMarius Sescu
https://www.hubspot.com/state-of-marketing
· Scaling relationships and proving ROI
· Social media is the place for search, sales, and service
· Authentic influencer partnerships fuel brand growth
· The strongest connections happen via call, click, chat, and camera.
· Time saved with AI leads to more creative work
· Seeking: A single source of truth
· TLDR; Get on social, try AI, and align your systems.
· More human marketing, powered by robots
ChatGPT is a revolutionary addition to the world since its introduction in 2022. A big shift in the sector of information gathering and processing happened because of this chatbot. What is the story of ChatGPT? How is the bot responding to prompts and generating contents? Swipe through these slides prepared by Expeed Software, a web development company regarding the development and technical intricacies of ChatGPT!
Product Design Trends in 2024 | Teenage EngineeringsPixeldarts
The realm of product design is a constantly changing environment where technology and style intersect. Every year introduces fresh challenges and exciting trends that mold the future of this captivating art form. In this piece, we delve into the significant trends set to influence the look and functionality of product design in the year 2024.
How Race, Age and Gender Shape Attitudes Towards Mental HealthThinkNow
Mental health has been in the news quite a bit lately. Dozens of U.S. states are currently suing Meta for contributing to the youth mental health crisis by inserting addictive features into their products, while the U.S. Surgeon General is touring the nation to bring awareness to the growing epidemic of loneliness and isolation. The country has endured periods of low national morale, such as in the 1970s when high inflation and the energy crisis worsened public sentiment following the Vietnam War. The current mood, however, feels different. Gallup recently reported that national mental health is at an all-time low, with few bright spots to lift spirits.
To better understand how Americans are feeling and their attitudes towards mental health in general, ThinkNow conducted a nationally representative quantitative survey of 1,500 respondents and found some interesting differences among ethnic, age and gender groups.
Technology
For example, 52% agree that technology and social media have a negative impact on mental health, but when broken out by race, 61% of Whites felt technology had a negative effect, and only 48% of Hispanics thought it did.
While technology has helped us keep in touch with friends and family in faraway places, it appears to have degraded our ability to connect in person. Staying connected online is a double-edged sword since the same news feed that brings us pictures of the grandkids and fluffy kittens also feeds us news about the wars in Israel and Ukraine, the dysfunction in Washington, the latest mass shooting and the climate crisis.
Hispanics may have a built-in defense against the isolation technology breeds, owing to their large, multigenerational households, strong social support systems, and tendency to use social media to stay connected with relatives abroad.
Age and Gender
When asked how individuals rate their mental health, men rate it higher than women by 11 percentage points, and Baby Boomers rank it highest at 83%, saying it’s good or excellent vs. 57% of Gen Z saying the same.
Gen Z spends the most amount of time on social media, so the notion that social media negatively affects mental health appears to be correlated. Unfortunately, Gen Z is also the generation that’s least comfortable discussing mental health concerns with healthcare professionals. Only 40% of them state they’re comfortable discussing their issues with a professional compared to 60% of Millennials and 65% of Boomers.
Race Affects Attitudes
As seen in previous research conducted by ThinkNow, Asian Americans lag other groups when it comes to awareness of mental health issues. Twenty-four percent of Asian Americans believe that having a mental health issue is a sign of weakness compared to the 16% average for all groups. Asians are also considerably less likely to be aware of mental health services in their communities (42% vs. 55%) and most likely to seek out information on social media (51% vs. 35%).
AI Trends in Creative Operations 2024 by Artwork Flow.pdfmarketingartwork
This article is all about what AI trends will emerge in the field of creative operations in 2024. All the marketers and brand builders should be aware of these trends for their further use and save themselves some time!
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
More than Just Lines on a Map: Best Practices for U.S Bike Routes
This session highlights best practices and lessons learned for U.S. Bike Route System designation, as well as how and why these routes should be integrated into bicycle planning at the local and regional level.
Presenters:
Presenter: Kevin Luecke Toole Design Group
Co-Presenter: Virginia Sullivan Adventure Cycling Association
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...DevGAMM Conference
Has your project been caught in a storm of deadlines, clashing requirements, and the need to change course halfway through? If yes, then check out how the administration team navigated through all of this, relocating 160 people from 3 countries and opening 2 offices during the most turbulent time in the last 20 years. Belka Games’ Chief Administrative Officer, Katerina Rudko, will share universal approaches and life hacks that can help your project survive unstable periods when there seem to be too many tasks and a lack of time and people.
This presentation was designed to provide strategic recommendations for a brand in decline. The deck also incorporates a situational assessment, including a brand identity, positioning, architecture, and portfolio strategy for the Brand.
Presentation originally created for NYU Stern's Brand Strategy course. Design by Erica Santiago & Chris Alexander.
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them wellSaba Software
According to the latest State of the American Manager report from Gallup, employees who have regular meetings with their managers are almost three times as likely to be engaged as those who don’t. These regular check-ins keep managers and employees in sync and aligned. Want to see better manager/employee relationships in your organisation? Then make an all-in commitment to 1:1 meetings. Not sure how? You’ve come to the right place.
In this webinar with Jamie Resker, Founder and Practice Leader for Employee Performance Solutions (EPS), and Teala Wilson, Talent Management Consultant at Saba Software, you’ll get the inside track on how to hold effective 1:1 meetings, including tips for getting managers on board.
• Go beyond discussing the status of everyday work to higher level topics, including recognition, performance, development, and career aspirations
• Learn how to decide meeting frequency, what to cover, as well as roles and responsibilities of the manager and employee
• Understand how managers can build trust and make it comfortable for employees to provide upward feedback
• Unite your organisation with a unified approach to 1:1 meetings
Join us for this 1-hour webinar to get practical tips for building better manager-employee relationships with intention and purpose.
About the Speakers
Jamie Resker - Founder and Practice Leader for Employee Performance Solutions (EPS)
Jamie Resker, Practice Leader and Founder of Employee Performance Solutions, is a recognized innovator in performance management. She is the originator of the-the Performance Continuum Feedback Method® and Conversations to Optimize Employee Performance training program; tools and training that reshape communications between managers and employees to drive and align performance. Jamie is on the faculty for the Northeast Human Resources Association, is a contributor to Halogen Software's Talent Space Blog, and is an editorial advisory board member for HR Examiner.
Teala Wilson - Senior Consultant, Strategic Services, Saba Software
Teala is a Talent Management Consultant at Halogen Software, now a part of Saba Software. She has worked with teams on a national and global level supporting human resources in areas such as performance management, recruitment, employee benefit programs, training and talent development, workforce planning and internal communications. Teala also has a personal passion for visual arts and design.
Want to learn more? Join us for an upcoming Product Tour!
http://bit.ly/2yitfqu
A report by thenetworkone and Kurio.
The contributing experts and agencies are (in an alphabetical order): Sylwia Rytel, Social Media Supervisor, 180heartbeats + JUNG v MATT (PL), Sharlene Jenner, Vice President - Director of Engagement Strategy, Abelson Taylor (USA), Alex Casanovas, Digital Director, Atrevia (ES), Dora Beilin, Senior Social Strategist, Barrett Hoffher (USA), Min Seo, Campaign Director, Brand New Agency (KR), Deshé M. Gully, Associate Strategist, Day One Agency (USA), Francesca Trevisan, Strategist, Different (IT), Trevor Crossman, CX and Digital Transformation Director; Olivia Hussey, Strategic Planner; Simi Srinarula, Social Media Manager, The Hallway (AUS), James Hebbert, Managing Director, Hylink (CN / UK), Mundy Álvarez, Planning Director; Pedro Rojas, Social Media Manager; Pancho González, CCO, Inbrax (CH), Oana Oprea, Head of Digital Planning, Jam Session Agency (RO), Amy Bottrill, Social Account Director, Launch (UK), Gaby Arriaga, Founder, Leonardo1452 (MX), Shantesh S Row, Creative Director, Liwa (UAE), Rajesh Mehta, Chief Strategy Officer; Dhruv Gaur, Digital Planning Lead; Leonie Mergulhao, Account Supervisor - Social Media & PR, Medulla (IN), Aurelija Plioplytė, Head of Digital & Social, Not Perfect (LI), Daiana Khaidargaliyeva, Account Manager, Osaka Labs (UK / USA), Stefanie Söhnchen, Vice President Digital, PIABO Communications (DE), Elisabeth Winiartati, Managing Consultant, Head of Global Integrated Communications; Lydia Aprina, Account Manager, Integrated Marketing and Communications; Nita Prabowo, Account Manager, Integrated Marketing and Communications; Okhi, Web Developer, PNTR Group (ID), Kei Obusan, Insights Director; Daffi Ranandi, Insights Manager, Radarr (SG), Gautam Reghunath, Co-founder & CEO, Talented (IN), Donagh Humphreys, Head of Social and Digital Innovation, THINKHOUSE (IRE), Sarah Yim, Strategy Director, Zulu Alpha Kilo (CA).
Trends In Paid Search: Navigating The Digital Landscape In 2024Search Engine Journal
The search marketing landscape is evolving rapidly with new technologies, and professionals, like you, rely on innovative paid search strategies to meet changing demands.
It’s important that you’re ready to implement new strategies in 2024.
Check this out and learn the top trends in paid search advertising that are expected to gain traction, so you can drive higher ROI more efficiently in 2024.
You’ll learn:
- The latest trends in AI and automation, and what this means for an evolving paid search ecosystem.
- New developments in privacy and data regulation.
- Emerging ad formats that are expected to make an impact next year.
Watch Sreekant Lanka from iQuanti and Irina Klein from OneMain Financial as they dive into the future of paid search and explore the trends, strategies, and technologies that will shape the search marketing landscape.
If you’re looking to assess your paid search strategy and design an industry-aligned plan for 2024, then this webinar is for you.
5 Public speaking tips from TED - Visualized summarySpeakerHub
From their humble beginnings in 1984, TED has grown into the world’s most powerful amplifier for speakers and thought-leaders to share their ideas. They have over 2,400 filmed talks (not including the 30,000+ TEDx videos) freely available online, and have hosted over 17,500 events around the world.
With over one billion views in a year, it’s no wonder that so many speakers are looking to TED for ideas on how to share their message more effectively.
The article “5 Public-Speaking Tips TED Gives Its Speakers”, by Carmine Gallo for Forbes, gives speakers five practical ways to connect with their audience, and effectively share their ideas on stage.
Whether you are gearing up to get on a TED stage yourself, or just want to master the skills that so many of their speakers possess, these tips and quotes from Chris Anderson, the TED Talks Curator, will encourage you to make the most impactful impression on your audience.
See the full article and more summaries like this on SpeakerHub here: https://speakerhub.com/blog/5-presentation-tips-ted-gives-its-speakers
See the original article on Forbes here:
http://www.forbes.com/forbes/welcome/?toURL=http://www.forbes.com/sites/carminegallo/2016/05/06/5-public-speaking-tips-ted-gives-its-speakers/&refURL=&referrer=#5c07a8221d9b
ChatGPT and the Future of Work - Clark Boyd Clark Boyd
Everyone is in agreement that ChatGPT (and other generative AI tools) will shape the future of work. Yet there is little consensus on exactly how, when, and to what extent this technology will change our world.
Businesses that extract maximum value from ChatGPT will use it as a collaborative tool for everything from brainstorming to technical maintenance.
For individuals, now is the time to pinpoint the skills the future professional will need to thrive in the AI age.
Check out this presentation to understand what ChatGPT is, how it will shape the future of work, and how you can prepare to take advantage.
A brief introduction to DataScience with explaining of the concepts, algorithms, machine learning, supervised and unsupervised learning, clustering, statistics, data preprocessing, real-world applications etc.
It's part of a Data Science Corner Campaign where I will be discussing the fundamentals of DataScience, AIML, Statistics etc.
Time Management & Productivity - Best PracticesVit Horky
Here's my presentation on by proven best practices how to manage your work time effectively and how to improve your productivity. It includes practical tips and how to use tools such as Slack, Google Apps, Hubspot, Google Calendar, Gmail and others.
The six step guide to practical project managementMindGenius
The six step guide to practical project management
If you think managing projects is too difficult, think again.
We’ve stripped back project management processes to the
basics – to make it quicker and easier, without sacrificing
the vital ingredients for success.
“If you’re looking for some real-world guidance, then The Six Step Guide to Practical Project Management will help.”
Dr Andrew Makar, Tactical Project Management
Unlocking the Power of ChatGPT and AI in Testing - A Real-World Look, present...Applitools
During this webinar, Anand Bagmar demonstrates how AI tools such as ChatGPT can be applied to various stages of the software development life cycle (SDLC) using an eCommerce application case study. Find the on-demand recording and more info at https://applitools.info/b59
Key takeaways:
• Learn how to use ChatGPT to add AI power to your testing and test automation
• Understand the limitations of the technology and where human expertise is crucial
• Gain insight into different AI-based tools
• Adopt AI-based tools to stay relevant and optimize work for developers and testers
* ChatGPT and OpenAI belong to OpenAI, L.L.C.
More than Just Lines on a Map: Best Practices for U.S Bike Routes
This session highlights best practices and lessons learned for U.S. Bike Route System designation, as well as how and why these routes should be integrated into bicycle planning at the local and regional level.
Presenters:
Presenter: Kevin Luecke Toole Design Group
Co-Presenter: Virginia Sullivan Adventure Cycling Association
Ride the Storm: Navigating Through Unstable Periods / Katerina Rudko (Belka G...DevGAMM Conference
Has your project been caught in a storm of deadlines, clashing requirements, and the need to change course halfway through? If yes, then check out how the administration team navigated through all of this, relocating 160 people from 3 countries and opening 2 offices during the most turbulent time in the last 20 years. Belka Games’ Chief Administrative Officer, Katerina Rudko, will share universal approaches and life hacks that can help your project survive unstable periods when there seem to be too many tasks and a lack of time and people.
This presentation was designed to provide strategic recommendations for a brand in decline. The deck also incorporates a situational assessment, including a brand identity, positioning, architecture, and portfolio strategy for the Brand.
Presentation originally created for NYU Stern's Brand Strategy course. Design by Erica Santiago & Chris Alexander.
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them wellSaba Software
According to the latest State of the American Manager report from Gallup, employees who have regular meetings with their managers are almost three times as likely to be engaged as those who don’t. These regular check-ins keep managers and employees in sync and aligned. Want to see better manager/employee relationships in your organisation? Then make an all-in commitment to 1:1 meetings. Not sure how? You’ve come to the right place.
In this webinar with Jamie Resker, Founder and Practice Leader for Employee Performance Solutions (EPS), and Teala Wilson, Talent Management Consultant at Saba Software, you’ll get the inside track on how to hold effective 1:1 meetings, including tips for getting managers on board.
• Go beyond discussing the status of everyday work to higher level topics, including recognition, performance, development, and career aspirations
• Learn how to decide meeting frequency, what to cover, as well as roles and responsibilities of the manager and employee
• Understand how managers can build trust and make it comfortable for employees to provide upward feedback
• Unite your organisation with a unified approach to 1:1 meetings
Join us for this 1-hour webinar to get practical tips for building better manager-employee relationships with intention and purpose.
About the Speakers
Jamie Resker - Founder and Practice Leader for Employee Performance Solutions (EPS)
Jamie Resker, Practice Leader and Founder of Employee Performance Solutions, is a recognized innovator in performance management. She is the originator of the-the Performance Continuum Feedback Method® and Conversations to Optimize Employee Performance training program; tools and training that reshape communications between managers and employees to drive and align performance. Jamie is on the faculty for the Northeast Human Resources Association, is a contributor to Halogen Software's Talent Space Blog, and is an editorial advisory board member for HR Examiner.
Teala Wilson - Senior Consultant, Strategic Services, Saba Software
Teala is a Talent Management Consultant at Halogen Software, now a part of Saba Software. She has worked with teams on a national and global level supporting human resources in areas such as performance management, recruitment, employee benefit programs, training and talent development, workforce planning and internal communications. Teala also has a personal passion for visual arts and design.
Want to learn more? Join us for an upcoming Product Tour!
http://bit.ly/2yitfqu
Good Stuff Happens in 1:1 Meetings: Why you need them and how to do them well
Cerebral ultralyd
1. Cerebral ultralyd
Sebastian Abel-Grüner, overlege ved barneradiologisk seksjon St. Olavs Hospital
Introduksjon og indikasjon
Cerebral ultralyd er eit veldig viktig verktøy for vurdering av hjernen ila. første leveår. Modaliteten blir brukt
som initial screening hos premature barn (GA < 37 veker) utan eller med kliniske funn. Tidspunktet for
screening og hyppigheten av intervall for seinare kontroller bør taes i diskusjon med ein neonatolog. Det er
imidlertid ikkje feil framgangsmåte å starte med første screening på levedag 2-3 og ta ein kontroll mot slutten
av første leveveka. Etter min meining burde all utredning av mistenkt hjernepatologi starte med ein henvisning
til ein UL caput, før ein seinare supplerer og fullfører utredninga med enten ein MR caput eller CT caput;
dersom fontanellen fortsatt er åpent. Dette gir eit raskt overblikk og kan veilede tidspunktet for supplerande
bildediagnostikk (litt som prinsippet: «UL galleblære og galleveier før utredning med MR CP»).
Vanlege kliniske problemstillingar som møter oss i kvardagen, enten i vaktsamanheng eller poliklinisk
(helsestasjon), og som raskt kan avklarast med ultralyd er:
Hydrocephalus (helst eksklusjon, men også seinare monitorering)
Blødninger hos premature
Anatomiske normalvarianter og (alvorlege) anomalier
Ekstrakraniale (fødselsrelaterte) hematomer
Kraniosynostose (avvikande hodeform)
Fødselsasfyksi (hypoksisk ischemisk encefalopati/HIE), periventrikulær leukomalaci (PVL) og kramper
Men her er det viktig å kjenne til begrensingane av UL som modalitet (MR er og forblir gullstandarden for vurdering av SNS
patologi)
Undersøkinga
Pasientforbereding
Planlegg tidspunkt for undersøkinga med sjukepleiere på forhånd; ikkje kom som drop-in. Får å kunne sjå inn i
hjernen via skallen forutsetter at via har god tilgang til heile hodet. Det hjelper ikkje å vere snill mot foreldrene
dersom barnet ligg i kenguru hud-mot-hud stilling med fiksert mekanisk ventilasjonsutstyr, slik at innsyn blir
suboptimalt. Rydd på hodet! Be sjukepleier løsne alt som kan løsnast og holde ventilasjonsutstyr. Bruk god tid
og gjerne ta med deg ein venn (erfaren kollege). Eldre barn (> 6 mnd) henvist fra poliklinikken eller helsestasjon
kan gjerne sitte trygt i foreldrenes fang og bli avleidd under undersøkinga. Bruk oppvarma slim (gelé).
Scanningsteknikk
Bruk ein eller gjerne fleire prober som gir best innsyn. Ein kurva sektorprobe (‘curvilinear’) (8-11 MHz) er
standard hos nyfødte.
2. Hos eldre barn kan en også forsøke mindre kurva abdominale/intervensjonsprober med lågare frekvens (5-8
MHz) for avklaring av grov patologi. Lineære prober (12-18 MHz) er ideelt for vurdering av dei overflatiske
strukturer (kortex, ekstraaksiale rom, overflatesinus, suturer, osv.), men kan også brukast til vurdering av
dypare beliggande strukturer hos nyfødte (særleg premature).
Systematisk vurdering er viktig og krever kunnskap i normal sonoanatomi. Fokuser på å framstille strukturer i to
plan, særleg ved patologi; eit par gode stillbilder er mykje bedre enn dårlege cineloop (filmsnutt). Imidlertid er
gode cineloop å foretrekke i sekundærvurdering og kontrasignerings øyemed. Husk hjernens «blindsoner»
(superolaterale konveksiteter, hypofysen og infratentorielle strukturer (ved innsyn via framre fontanellen).
Hos nyfødte bruker vi vanlegvis frame fontanellen som det dominante akustiske vindu i coronale og
sagittale/skråsagittale plan. Bakre fontanellen kan brukast for vurdering av strukturer i relasjon til occipitalhorn
(spes. deklive blodprodukter intraventrikulært). Mastoidfontanellen gir god oversikt for dei infratentorielle
strukturer / bakre fossa (cerebellum, venesinus, osv.). Sistnevnte to blir dog sjeldent brukt i rutine screening
hos nyfødte. Framre fontanellen vil lukkast til slutt og kan i enkelte tilfeller vere patent fram til 1,5 – 2 års alder.
3. I coronalplanet er det viktig å vurdere strukturer i 6 standard bilder. Dette planet er desidert viktigast for
vurdering av heile hjernen. For detaljert analyse av strukturer i kvart bilde henvisast til artikkelreferanser
(radiopaedia og pediatricfoam). Bildevindu nr. 3 (foramen Monroe nivå) er det vitkigaste stillbildet, da vi her
vurderer patologi relatert til ventrikkelens storleik og ev. hydrocephalus forandringer.
4. I sagittalplanet er det viktig å vurdere strukturer i 5 standard bilder. Dette planet er desidert viktigast for
vurdering av subependymale blødninger, blod i occitpalhorn og anomalier i midtlinjen. Start i midtlinjen og vift
sakte mot kvar lateralside. Sideventriklane divergerer meire occipitalt så det optimale bildet for vurdering av
caudothalamiske gropen og plexus choroideus i heile sin lengde framstillast i eit skråsagittalt plan.
I transversalplanet gjennom temporalvindu fåes god anatomisk oversikt over strukturer i bakre fossa.
6. Kva anatomiske områder er av interesse for oss?
Caudothalamiske gropen
Ventrikkelsystemets sideventrikler i nivå med tredje ventrikkel (coronalplan) samt occipitalhorn i heile
sin lengde (skråsagittalplan)
Periventrikulære kvitsubstansen (særleg i trionumområdet att med occipitalhorn)
Basalganglier (nucleus caudatus et lentiformis) og thalamus
Subarachnoidalrom
Kortex og gyreringsmønster (iht. gestasjonsalder / GA)
Midtlinjestrukturer (Corpus callosum, tredje og fjerde ventrikkel, vermis cerebelli, hjernestammen, vena Galeni)
Ekstrakraniale strukturer (suturer, aponeurosis epicranialis)
Kva områder ser vi ikkje / har vi begrensa erfaring med å vurdere?
Laterale / craniolaterale områder omkring cerebralkonveksiteter
Bakre skallegrop og basale cisternerom
Arterier og vener
Her må vi kjenne til begrensinger av UL som modalitet og gi anbefaling om henvisning til supplerande
modaliteter for avklaring av ikkje framstilte områder eller patologi av omfattande karakter (f.eks.
fødselsasfyksi). MR vil vere gullstandarden for vidare utredning. CT caput har begrensa rolle i diagnostikk av
sjukdomar hos nyfødte og spedbarn; unntak vil vere hodetraumer (uhell eller påført), preoperativ
kraniosynostose utredning og suppl. kartlegging av maligne lesjoner m/affeksjon av bein (f.eks. Langerhanscelle
histiocytose eller beinsarkomer).
Hos dette terminbarn med mekoniumaspirasjon utan fødselsasfyksi ga UL caput mistanke om ein sentral
ischemi (HIE) pga. hyperekkogene forandringer i venstre basalganglier og insula. Omfang av skaden er kraftig
undervurdert samanlikna med MR caput 2 timer seinare (diffusjon).
7. Anatomiske normalvarianter, kongenitale anomalier og DD
Intrakranielle cyster
Flesteparten av dei intrakraniale cystene vil vere benigne. Lokalisasjonen til cystene er det viktigaste
kjenneteikn å skille desse fra kvarandre, samt skille normalvarianter frå patologi. Dessutan vil dei fleste
patologiske cyster utviklast over tid da desse er sekvele etter gjennomgått blødning og/eller ischemi.
Cavum septi pellucidi
Normalvariant. Tilstede hos alle premature barn. Kan persistere mot voksenalder.
Dersom ein ikkje ser denne hos premature mistenk hjerneødem (f.eks. HIE).
Cavum vergae
Beliggande ventralt for splenium corporis callosi.
Cavum veli interpositi
Beliggande i tectumregionen
Plexus choroideus cyster
Oftast solitær, unilteral og små (< 1 cm). Utan klinisk betydning.
Bilaterale og store cyster (> 1 cm) kan vere assosiert med Trisomi 18.
Connatalcyster (koarktasjons- / pseudocyster)
Benigne cyster utan klinisk relevans. Går som oftast i full regress innan 1-2 mnd etter fødsel.
Beliggande superolateralt ved sideventrikkelens forhorn. Gjerne bilateralt og mot frontalregioner.
Subependymale cyster
Beliggande i nivå / like baktil med foramen Monro. To typer:
A. Posthemorrhagisk / -ischemisk / -metabolsk
I dei aller fleste tilfeller sekvele etter gjennomgått subependymale
blødninger (germinalmatrix blødninger/GMH). Gjerne komplekse
cyster med septeringer (sjå bildet); til forskjell fra germinolytiske
cyster og ventralt beliggande plexuscyster (tynnvegga og unilokulær)
B. Kongenital
Relatert til germinolyse (‘germinolytiske cyster’). Ukjent etiologi.
Klinisk irrelevant.
Porencephale cyster
Sekvele etter venøse infarkter (grad 4 blødninger, posthemorrhagiske ischemi /PHI). Lokal substanstap av
periventrikulære kvitsubstansen.
8. PVL grad 2
PVL grad 3
PVL grad 4
Periventrikulær leukomalaci (PVL)
Dei type intrakranielle cyster med dårlegast prognose på sikt (cerebral parese/CP). Sekvele hos premature barn
etter ischemisk skade (HIE) i vannskilleområder i periventrikulære kvitsubstansen. Kan vere vanskeleg å
diagnostisere ved UL i akutt/tidleg fase (vil oftast utvikle seg ila. 2-6 veker etter det vaskulære insultet).
Beliggande ovanfor sideventrikler, i sentrum semiovale og i posterior/occipital distribusjonsmønster.
Fire grader; der grad 2-4 klassifiserast med cyster:
2. Små, multiple cyster i tilknytting til periventrikulære kvitsubstansen
3. Uttalte multiple cyster i periventrikulære områder, men også mot dype kvitsubstansen occipitalt og
frontoparietalt
4. Som grad 3, men no også omfattande subkortikale cyster
‘’Flaring’’
Denne tilstanden må skillast fra normal ‘peritrigonal blush’ / ‘periventricular halo’ / hyperechoic pseudolesions’
(som skyldast anisotropieffekt). Dette er områder med fysiologisk auka ekkogenisitet frontalt, inferolerateralt
eller occipitalt for sideventrikler hos premature nyfødte. Forandringer vil vere subtile (hypoekkoisk ifht. plexus
choroideus) og symmetriske. Undersøk i fleire plan og kontroller over tid derom usikkerheit.
Definisjon av «flaring» = Unormal / ikkje-fysiologisk periventrikulær ekkogenisitet som er iso-/hyperekkoisk sml.
med plexus choroideus. Gjerne inhomogen og asymmetrisk utsjånad. Oftast i trigonumområdet (paritealt).
9. Definisjon av PVL grad 1 = persisterande ‘flaring’ /hyperekkogenisitet (> 7 dager) i periventrikulære områder
utan cystedanning. Gjerne asymmetrisk, grovt og meire hyperekkogent enn plexus choroideus. Ingen
masseeffekt (som ved f.eks. grad 4 blødninger eller parenchymblødninger).
Corpus callosum agenesi
Oftast diagnostisert antenatalt. Dei fleste kongenitale malformasjoner er vanskeleg å diagnostisere ved UL
(f.eks. subependymal heterotopi, kortikal dysplasi, lissencephali, polymicrogyri og schizencephali, Chiari 2
malformasjoner, osv.). Her skinner igjen MR caput. Unntak vil vere corpus callosum patologi der ein relativt lett
kan enkelt uttale seg om dysgenesi, partiell agenesi eller komplett agenesi (gjerne ass. med andre
malformasjon).
Her er eksempler av komplett agenesi (tillegg: auka avstand til sideventrikkelens forhorn og fråvær av pericallos
arteriene) samt partiell agenesi.
Vena Galeni aneurysmatisk malforasjon
Ein sjelden vaskulær kongenital anomali, utgjer < 1% av alle
intrakranielle vaskulære malformasjoner. Imidlertid den
lettaste å vurdere ved doppler UL i midtlinjen sagittalt.
I tillegg til kompresjon av tett inntilligande strukturer, kan
den medføre til uttalte hemodynamiske forandringer i andre
områder i den nyfødtes kropp.
10. Viktigaste patologiske tilstander
Blødninger
Germinalmatrix (celleplaten) er eit midlertidig cellerikt, høg vaskularisert område der neuroblaster dannast.
Denne er lokalisert i subependymale regioner til lateralventrikler ved caudothalamiske gropene. Den
inneholder skjøre blodkar som er utsatt for ruptur ved variasjoner i neonatale belastninger. Germinalmatrix
tilbakedannast gradvis og er komplett omkring veke 36-37. Dei aller fleste (~95%) blødninger hos premature
forekommer ila. første leveveka; gjerne på dag 1 eller 2.
I praksis graderast neonatale blødninger etter Papille (CT basert) og Volpe (UL basert) klassifikasjonssystem.
Grad 1 og 2 har gjerne lite / vage symptomer og kun få prosent får neurologiske sekveler. Grad 3 og 4 kan gi
meire alvorlege symptom med respirasjonsdepresjon, apné, unormal kroppsholdning og bulande fontanelle.
Grad 1 - Subependymal blødning (germinalmatrix blødning / GMH)
- Velavgrensa hyperekkoisk forandring i caudothalamiske grop
11. Grad 2 - Ekstensjon av blod i ventrikkelsystemet (intreventrikulær blødning / IVH)
- Hyperekkoiske forandringer fortil caudothalamiske groper er blodkoagler (plexus choroideus strekker
seg ikkje så langt ventralt, men vil avsmalne jevnt mot gropen)
Grad 3 - Som grad 2 IVH, men i tillegg utvida ventrikkelsystem i sideventrikler
- >50% av arealet (skråsagittalt plan) vil vere blodfylt
Grad 4 - Intraparenchymal blødning som antas å skyldast venøst infarkt (periventrikulært hemorrhagisk
infarkt / PHI) i motsetning til tidl. tankegang om ekstensjon / gjennombrudd av IVH
Anmerkninger:
NB! Neonatale blødninger kan vere stabile, progrediere eller gå i full regress. Ein bruker imidlertid ikkje å sei
«Grad 3 blødning (GMH+IVH) har subtotalt regrediert til ein grad 1 blødning (IVH)». Blødninger vil alltid
definerast som den mest alvorlege graden. Dei kan vere bilateralt med ulik alvorlegheitsgrad på kvar side.
Treng ikkje slavisk følge prinsipp grad 1 blir til grad 2 som blir til grad 3 og til slutt grad 4.
Grad 3 blødning (GMH+IVH) med posthemorrhagisk dilatasjon
(PHVD) og kjemisk ventrikulitt (hyperekkogene forandringer i
ventrikkelveggen)
12. Hydrocephalus
Ventrikkelasymmetri
Tilstede hos opptil 5-12% av friske barn og sjeldant utrykk for patologi. Dei
fleste artikler definerer dette som ein forskjell på > 2 mm i ventrikkelbredden.
Hos nyfødte (enten premature eller terminbarn) er mindre forandringer
gjerne leiebetinga. Occipitalhorn med størst forskjell. Dersom store forskjeller
kan ein gjer ein UL screening og ev. kontroll for å sjå etter underliggande
patologi (sekvele etter unilateral antenatal blødning, periventrikulær
parenchymtap, obstruktive lesjoner i foramina Monro, andre kongenitale
anomalier).
Godarta ekstern hydrocephalus (‘benign enlargement of the subarachnoidal spaces / BESS)
Kan vere ‘bifunn’ ved undersøking av spedbarn (> 3-6 mnd) henvist frå helsestasjon pga. makrocefali (har
kryssa fleire percentiler). Gjerne spontan bedring omkring 2 år. Veldig sjeldan med komplikasjoner eller
sekveler (forsinka psykomotorisk utvikling osv.)
Affiserar vanlegast dei bifrontale subarachnoidalrom. Må ekskludere anna underliggande patologi (f.eks.
ekstraaksiale hematomer, atrafrofi sekundært til leukoencephalomalaci, …). Største bredder målast i
coronalplanet i nivå med foramen Monro.
SCW - sinocortical width
CCW - craniocortical width
IHW - interhemisperical width
Ingen offisiell konsensus for grenseverdier (cutt-off). Uptodate har ingen ref.verdier for UL, men angir verdier
over 2SD eller >97,5 percentilen for hodeomkrets som patologisk. Radiopaedia bruker verdier IHW > 5 mm hos
nyfødte og IHW > 8,5 mm hos 1-åringer. Radiologyassistant har gode oversiktstabeller med forslag på
normalverdier for spes. alder fram til 1 år.
Utviding av ventrikkelsystemet
Ventrikulomegali er det foretrukne begrepet for forstermedisinerne. Medan hydrocephalus blir brukt om
ventrikulomegali der det også foreligg auka CSF trykk i ventrikkelsystemet. Hydrocephalus inndelast gjerne i to
kategorier; ikkje-kommuniserande / obstruktiv (kongenital akveduktstenose og Dandy-Walker anomalier, men
svært sjeldne tilstand) og kommuniserande (resoprsjonssvikt sekundært til blødning, infeksjon eller kongenitale
anomalier).
13. Hos nyfødte er det ikkje alltid lett å skille desse frå kvarandre ved ultralyd og den inndelinga brukast derfor
sjeldant. Den hyppigaste årsaken til utviding av ventrikkelsystemet er forårsaka av neonatale blødninger, enten
i samanheng med at blødningen har oppstått ila. første leveveka (minst grad 3 GMH+IVH) eller i tida etterpå,
gjerne omkring dag 10-15 (posthemorrhagisk ventrikkeldilatasjon / PHVD).
Hos spedbarn gjer vi ein subjektiv vurdering av ventrikkelsystemet og supplerer gjerne utredninga med MR
caput (forsøk på etiologisk avklaring, alvorsgrad, ass. anomalier). Dei fleste røntgenavdelinger har nok denne
referanse-sjablongen hengande på veggen. Helst ikkje bruk denne (manglande /utdatert artikkelreferanse!).
Grad 3 blødning (GMH+IVH) Dandy-Wlaker malformasjon
(dilatasjon av 4. ventrikkel og
cisterner i bakre fossa)
14. I tillegg til ein subjektiv vurdering av ventrikkelsystem gjer vi hos nyfødte ein objektiv storleiks vurdering av
ventrikkelsystemet. Dei tre viktigaste mål er:
VI (‘ventricular index’)
- Målast coronalt i nivå med / rett bak foramen Monro
- Aldersavhenging
AHW (‘anterior horn width’)
- Største bredden coronalt fortil foramen Monro
- Relativt statisk
TOD (‘thalamooccipital distanse’)
- Skråsagittal fra bakre thalamus til dypaste occipitalhorn
- Vanskeleg og mest brukervariasjon
- Angiveleg mest sens. for begynnande hydrocephalus
15. Perifer HIE mønster (perirolandisk kortex hyperekkogenisitet)
Sentral HIE mønster (basalganglier hyperekkogenisitet og
komprimerte væskerom)
Neonatal hypoksisk ischemisk encefalopati (HIE)
Ein av dei vanlegaste årsaker til cerebral parese og andre alvorlege neurologiske utfall hos barn; ca. 2-9/1000
levande født barn. Relatert til perinatal fødselsasfyksi hos premature (PVL), men også terminbarn
(hemorrhagiske infarkter). Redistribusjon av blood til hjernen kan føre til multiorgansvikt. Initialt vil ultralyd
vere normal. Kontroll ultralyd vil kunne vise cerebralt ødem i form av hyperekkoiske forandringer perifert (tap
av grå-/kvitsubstans differensiering), men også sentralt (basalganglier og thalami) samt komprimerte
væskerom perifert og sentralt. Resistens indeks (RI) i pericallosaarteriene og a. cerebri media kan brukast til
vurdering (gjerne redusert RI pga. arteriell vasodilatasjon). Dei indirekte sonografiske teikn må bekreftast med
MR caput (gjerne m/spektroskopi); som vil kunne skille bedre mellom eit perifert HIE mønster og sentralt HIE
mønster (meir omfattande og langvarige anoksi skader!).
Lentikulostriatal vaskulopati
Forkalkninger i kvarveggen i relasjon til dei thalamostriatale og lentikulostriatale arterier. Stort spekter av
bakenforliggende etiologi – alt frå periantale infeksjoner (TORCH) til uspesifikke postnatalt erverva tilstander.
Sonografisk sjåast desse som uni- eller bilaterale, lineære (eller punktate), hyperekkoiske områder i
basalganglier og thalami. Følger blodkarene. Konklusjon: Uspesifikt ultralydfunn.
16. Eldre subduralt hematom venstre side
Cephalohematom og os parietale fraktur
Ekstraaksiale og ekstrakraniale hematomer
Ultralyd kan brukast til vurdering av ekstraaksiale
hematomer (epidurale, subdurale, subarachnoidale), men
dei fleste vil «gjemme» seg langs perifere konveksitetene.
Oftast ser vi effekten av store blødninger; f.eks. utplanering
av overflaterelieff og særleg midtlinjeforskyving. I slike
tilfeller bør ein rask henvise til supplerande CT caput og/eller
MR caput.
Ekstrakraniale hematomer er gjerne traumatisk erverva; enten etter fall eller ifbm. forløsning (f.eks. vakuum).
Caput succedaneum
= subkutan væskeansamling superficielt for aponeurosen
Subgalealt hematom
= mellom periost og aponeurosen, kan krysse suturer
Cephalohematom
= subperiostalt, kan ikkje krysse suturer, kan bli perifert
kalsifisert etter 2-3 veker (palpatorisk beinharde)
Kraniosynostose
Unormal eller for tidleg lukning av ein eller fleire kraniale sømmer (suturer) som medfører til endra
vekstmønster i hodeskallen (avvikande hodefasong). Ultralyd bør vere første modalitet for avklaring av denne
tilstanden. Dersom barnet er for uroleg eller innsyn er for dårleg kan ein røntgen caput vurderast som andre
utredningsmodalitet. CT caput bør kun henvisast av neurokirurg ifbm. preoperativ planlegging.
17. Eksempel på radiologisk rapport med normale funn:
«Pasient i ryggleie, høyre sides hode ned. Innsyn via fremre fontanelle.
Ingen forøket væskemengde over konveksitetene i midtlinjen. Slanke, symmetrisk utseende sideventrikler.
Cavum septi pellucidi. Slank tredje og fjerde ventrikkel. Ingen subependymale blødninger eller
intraventrikulære blodprodukter. Aldersnormal ekkogenisitet periventrikulært frontoparietalt og i
basalganglier bilateralt. Normale midtlinjestrukturer.
R: Normale funn»
Eksempel på radiologisk rapport med patologi:
«Pasienten i ryggleie, hodet rett frem. Innsyn via fremre fontanelle.
Ingen forøket væskemengde over konveksitetene i midtlinjen. Lettgradig utvidelse av sideventrikler; forøkete
forhornsbredder (AHW) og bakhornsdybder (TOD); se tabell. Best synlig på venstre side grunnet lite koageler
intraventrikulært. På høyre side er sideventrikkelen subtotalt utfylt av koageler (unntatt frontalhorn). I tillegg
foreligg det her hyperekkoiske forandringer periventrikulært i trigonumområdet (parietooccipitalt); godt
forenlig med et periventrikulært hemorraghisk infarkt (PHI). I venstre sideventrikkelen foreligger en
subependymal blødning og koageler/blødning langs plexus choroideus (utfyller < 50% av arealet), sparsomt
med koageler i forhorn; grunnet lett ventrikkeldilatasjon vurderes dette samlet sett som en GMH+IVH grad 3.
Slank tredje og fjerde ventrikkel. Ingen midtlinjeforskyvning. Normal corpus callosum.
R: Grad 4 blødning høyre side (GMH+IVH+PHI). Grad 3 blødning venstre side (GMH+IVH).»
HØ VE
Ventrikkelindeks (VI) 10 mm 10 mm
Forhornsbredde (AHW) 6 mm 6 mm
Thalamoocc. avstand (TOD) 21 mm 18 mm
18. Referanser
Å mestre cerebral ultralyd krever to ting. Praktisk øving og repetisjon («There are no shortcuts – everything is
reps, reps, reps.» Arnold Schwarzenegger). I tillegg finst det utroleg masse god litteratur. Eg anbefaler å lese
minst ein av dei tre først nevnte oversiktsartikler:
Caro-Dominguez P. et.al.: Cranial ultrasound for beginners, Transl Pediatr 2021
Ciocan I. et.al.: Transfontanellar ultrasound in preterm infants – a survival guide for the young radiologist on
call, ECR 2017
Toma p. et.al.: Brain Sonography, Pediatric Neuroradiology 2015
Concalves F.G. et.al.: Superficial anatomy of the neonatal cerebrum – a ultrasonographic roadmap, Pediatric
Radiology 2021
Epelman M. et.al.: Differential Diagnosis of Intracranial Cystic Lesions at Head US: Correlation with CT and
MRI Imaging, RadioGraphics 2006
Guillerman R.P.: Infant Craniospinal Ultrasonography: Beyond Hemorrhage and Hydrocephalus, Semin
Ultrasound CT MRI 2010
Agut T. et.al.: Preterm white matter injury: ultrasound diagnosis and classification, Pediatric Research 2020
Fumagalli M. et.al.: Ultrasound of acquired posterior fossa abnormalities in the newborn, Pediatric Research
2020
Enriquez G. et.al.: Mastoid fontanelle approach for sonographic imaging of the neonatal brain, Pediatric
Radiology 2006
El-Dib M. et.al.: Managment of Post-hemorrhagic Ventricular Dilatation in the Preterm Infant, J Pediatr 2021
Pogliani L. et.al.: Cranial ultrasound is a reliable first step imaging in children with suspected craniosynostosis,
Child’s Nervous System 2017
Meijler G. et.al.: Trancranial Doppler Sonography in Neonates, Neonatal Cranial Ultrasonography 2019
https://radiologyassistant.nl/pediatrics/spine/neonatal-brain-us
https://radiopaedia.org/articles/head-ultrasound
https://www.paediatricfoam.com/2021/05/cranial-ultrasound/
https://www.uptodate.com/contents/germinal-matrix-hemorrhage-and-intraventricular-hemorrhage-gmh-ivh-
in-the-newborn-prevention-management-and-complications
https://sonographictendencies.com/2016/11/07/neonatal-neursonography/
https://www.youtube.com/watch?app=desktop&v=inYV8edCVgA
(WFPI Webinar Series- "Neonatal Cranial Ultrasound- tricks of the trade" by Prof. Dorothy Bulas)