• Cranial sonography is the ideal imaging tool for use in infants. However, it has not been used for the diagnosis of cerebral atrophy in infants as the subarachnoid space has been a "blind spot" with ultrasound. We evaluated cerebral atrophy by a unique application of cranial sonography that we have termed the near-field method, and compared these results with those of cranial computed tomography (CT). We examined 106 infants with the near-field method of cranial sonography. Eleven patients fitted our sonographic criteria for cerebral atrophy. Cranial CT was done in eight of the 11 patients with sonographic findings of cerebral atrophy and was consistent with the diagnoses of cerebral atrophy in all cases. Of these eight patients, one had cerebral atrophy and subdural effusion seen by both nearfield sonography and cranial CT. Cranial CT was performed in eight of the 95 patients with normal sonographic findings, and all results were normal. All patients with cerebral atrophy determined by cranial CT were found to have cerebral atrophy by near-field sonography. Likewise, all patients without cerebral atrophy by cranial CT were not found to have cerebral atrophy CA by near-field sonography. The near-field method of cranial sonography therefore appears to have a sensitivity and specificity of 100% with cranial CT as a referral method.