Abdo A, Castellanos R, Ruiz A, del Valle O, Benítez Y, Suarez-López J, Machado RE, Espinosa N, Gutiérrez JA, Castellanos A, González D, Leal G, Gómez F, Quiles L, López JC, Jordán J, Vázquez F

Language: Spanish
References: 17
Page: 21-30
PDF size: 728.26 Kb.

ABSTRACT

Introduction: Color-coded transcranial duplex sonography is a technique not widely used in intensive medicine for the evaluation of neurocritical patients. Characteristics such as noninvasiveness, reproducibility, possibility of being performed at bedside and obtaining the color Doppler spectrum of the cerebral vasculature together with two-dimensional images of brain structures make it an attractive technique.
Objective: to correlate third ventricle measurement and midline shift by color coded transcranial duplex sonography with computed tomography measurements.
Method: we studied 12 neurocritical patients admitted to the Intensive Care Unit of the Center of Surgical and Medical Research, which were measured by color-coded transcranial duplex sonography, third ventricle and midline shift. Measurements were correlated with computed tomography. Pearson correlation coefficient was determined.
Results: mean values of third ventricle and midline shift were 5.67 mm (± 2.76) and 1.90 mm (± 1.65) for color-coded transcranial duplex sonography and 5.80 mm (± 3.11), 1.25 mm (± 1.34) by computed tomography; correlation coefficients (r=0.85, p ‹ 0.001 and r=0.69, p=0.013).
Conclusions: color-coded transcranial duplex sonography is useful for measurements of the third ventricle and midline shift, as there is an adequate correlation with computed tomography measurements.

REFERENCES

1. Aaslid R, Markwalder TM, Nornes H. Noninvasive transcranial Doppler ultrasound recording of flow velocity in basal cerebral arteries. J Neurosurg. 1982 Dec;57(6):769-74

2. Bogdahn U, Becker G, Winkler J, Greiner K, Perez J, Meurers B. Transcranial color-coded real-time sonography in adults. Stroke. 1990 Dec;21(12):1680-8

3. Blanco P. Transcranial Color-Coded Duplex Sonography: Another Option Besides the Blind Method. J Ultrasound Med. 2016 Mar;35(3):669-71

4. Blanco P, Blaivas M. Applications of transcranial color-coded sonography in the emergency department. J Ultrasound Med. 2017 Feb 27. Epub ahead of print

5. Seidel G, Kaps M, Gerriets T, Hutzelmann A. Evaluation of the ventricular system in adults by transcranial duplex sonography. J Neuroimaging. 1995 Apr;5(2):105-8

6. Seidel G, Gerriets T, Kaps M, Missler U. Dislocation of the third ventricle due to space-occupying stroke evaluated by transcranial duplex sonography. J Neuroimaging. 1996 Oct;6(4):227-30

7. Scherle-Matamoros CE. Comparación del diámetro del III ventrículo mensurado por dúplex transcraneal y tomografía computada de cráneo. Rev Mex Neuroci 2014; 15(4): 197-200

8. Pappu S, Lerma J, Khraishi T. Brain CT to Assess Intracranial Pressure in Patients with Traumatic Brain Injury. J Neuroimaging. 2016 Jan-Feb;26(1):37-40.

9. Sagher O. Treatment guidelines from the Brain Trauma Foundation. J Neurosurg. 2013 Nov;119(5):1246

10. Aiolfi A, Khor D, Cho J, Benjamin E, Inaba K, Demetriades D. Intracranial pressure monitoring in severe blunt head trauma: does the type of monitoring device matter? J Neurosurg. 2017 May 26:1-6.

11. Shen L, Wang Z, Su Z, Qiu S, Xu J, Zhou Y, et al. Effects of Intracranial Pressure Monitoring on Mortality in Patients with Severe Traumatic Brain Injury: A Meta-Analysis. PLoS One. 2016 Dec 28;11(12): e0168901.

12. Murillo-Cabezas F, Arteta-Arteta D, Flores-Cordero JM, Muñoz-Sánchez MA, Rincón-Ferrari MD, Rivera-Fernández MV, et al. The usefulness of transcranial Doppler ultrasono-graphy in the early phase of head injury. Neurocirugia (Astur). 2002 Jun;13(3):196-208.

13. Abdo A, Pérez-Bernal J, Hinojosa R, Porras F, Castellanos R, Gómez F, et al. Cerebral Hemodynamics Patterns by Transcranial Doppler in Patients With Acute Liver Failure. Transplant Proc. 2015 Nov;47(9):2647-9.

14. Oliveira RAG, de Oliveira Lima M, Paiva WS, de Sá Malbouisson LM, Teixeira MJ, Bor-Seng-Shu E. Comparison between Brain Comp-uted Tomography Scan and Transcranial Sonography to Evaluate Third Ventricle Width, Peri-Mesencephalic Cistern, and Sylvian Fissure in Traumatic Brain-Injured Patients. Front Neurol. 2017, 8:44.

15. Hernández NL, Escrivá AG, Jordà JM. Study of the diameter of the third ventricle with transcranial sonog-raphy. Neurologia. 2007 Oct;22(8):507-10

16. Stolz E, Gerriets T, Fiss I, Babacan SS, Seidel G, Kaps M. Comparison of transcranial color-coded duplex sonography and cranial CT measurements for determining third ventricle midline shift in space-occupying stroke. AJNR Am J Neuroradiol. 1999 Sep;20(8):1567-71.

17. Wijnhoud AD, Franckena M, van der Lugt A, Koudstaal PJ, Dippel ED. Inadequate acoustical temporal bone window in patients with a transient ischemic attack or minor stroke: role of skull thickness and bone density. Ultrasound Med Biol. 2008 Jun;34(6): 923-9.