Intracranial epidural hematoma follow-up using bidimensional ultrasound

Lacerda, Fábio Holanda; Rahhal, Hassan; Soares, Leonardo Jorge; Ureña, Francisco del Rosario Matos; Park, Marcelo

doi:10.5935/0103-507x.20170036

Cited by 9 publications

(5 citation statements)

References 3 publications

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“…Subdural hematoma: described as hypoechoic fluid collection surrounding the brain parenchyma within skull margins was not well appreciated in our study despite 4 patients scanned in our study having subdural hematoma on corresponding CT scans 38,49,50 (Figure 16). Epidural hematoma: hypoechoic fluid collection surrounding the brain parenchyma has been described in one published study 38,51 . We did not have any patients with epidural hematoma in our enrolled study population. Tumors: visualized as well‐defined round structures indistinguishable from hemorrhage.…”

Section: Resultsmentioning

confidence: 98%

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Brain topography on adult ultrasound images: Techniques, interpretation, and image library

Kapoor

Offnick

Allen

et al. 2022

Journal of Neuroimaging

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Background and Purpose Many studies have explored the possibility of using cranial ultrasound for discerning intracranial pathologies like tumors, hemorrhagic stroke, or subdural hemorrhage in clinical scenarios where computer tomography may not be accessible or feasible. The visualization of intracranial anatomy on B‐mode ultrasound is challenging due to the presence of the skull that limits insonation to a few segments on the temporal bone that are thin enough to allow transcranial transmission of sound. Several artifacts are produced by hyperechoic signals inherent in brain and skull anatomy when images are created using temporal windows. Methods While the literature has investigated the accuracy of diagnosis of intracranial pathology with ultrasound, we lack a reference source for images acquired on cranial topography on B‐mode ultrasound to illustrate the appearance of normal and abnormal structures of the brain and skull. Two investigators underwent hands‐on training in Cranial point‐of‐care ultrasound (c‐POCUS) and acquired multiple images from each patient to obtain the most in‐depth images of brain to investigate all visible anatomical structures and pathology within 24 hours of any CT/MRI imaging done. Results Most reproducible structures visible on c‐POCUS included bony parts and parenchymal structures. Transcranial and abdominal presets were equivalent in elucidating anatomical structures. Brain pathology like parenchymal hemorrhage, cerebral edema, and hydrocephalus were also visualized. Conclusions We present an illustrated anatomical atlas of cranial ultrasound B‐mode images acquired in various pathologies in a critical care environment and compare our findings with published literature by performing a scoping review of literature on the subject.

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Section: Resultsmentioning

confidence: 98%

“… Epidural hematoma: hypoechoic fluid collection surrounding the brain parenchyma has been described in one published study. 38 , 51 We did not have any patients with epidural hematoma in our enrolled study population. Tumors: visualized as well‐defined round structures indistinguishable from hemorrhage.…”

Section: Resultsmentioning

confidence: 99%

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

Kapoor

Offnick

Allen

et al. 2022

Journal of Neuroimaging

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“…We also excluded parenchymal assessment for diagnosis of cerebral edema using TCU, due to significant heterogeneity in its sonographic appearance, based on our own experience and a few published studies 4,22,26,37,39 . We only found case reports for epidural hematoma that did not meet the study eligibility criteria 66,69 …”

Section: Discussionmentioning

confidence: 99%

“…4,22,26,37,39 We only found case reports for epidural hematoma that did not meet the study eligibility criteria. 66,69 Strengths of our review include duplicity in the process of study selection and data extraction to limit bias and increase the study's validity. We did not find any other reviews in selected medical databases or gray literature that have evaluated the literature on TCUbased diagnosis of intracranial pathology.…”

Section: Ultrasound Competencies and Expertisementioning

confidence: 99%

Transcranial ultrasonography to detect intracranial pathology: A systematic review and meta‐analysis

Allen

Kapoor

Anzalone

et al. 2023

Journal of Neuroimaging

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Background and Purpose Transcranial ultrasonography (TCU) can be a useful diagnostic tool in evaluating intracranial pathology in patients with limited or delayed access to routine neuroimaging in critical care or austere settings. We reviewed available literature investigating the diagnostic utility of TCU for detecting pediatric and adult patient's intracranial pathology in patients with intact skulls and reported diagnostic accuracy measures. Methods We performed a systematic review of PubMed®, Cochrane Library, Embase®, Scopus®, Web of Science™, and Cumulative Index to Nursing and Allied Health Literature databases to identify articles evaluating ultrasound‐based detection of intracranial pathology in comparison to routine imaging using broad Medical Subject Heading sets. Two independent reviewers reviewed the retrieved articles for bias using the Quality Assessment of Diagnostic Accuracy Studies tools and extracted measures of diagnostic accuracy and ultrasound parameters. Data were pooled using meta‐analysis implementing a random‐effects approach to examine the sensitivity, specificity, and accuracy of ultrasound‐based diagnosis. Results A total of 44 studies out of the 3432 articles screened met the eligibility criteria, totaling 2426 patients (Mean age: 60.1 ± 14.52 years). We found tumors, intracranial hemorrhage (ICH), and neurodegenerative diseases in the eligible studies. Sensitivity, specificity, and accuracy of TCU and their 95% confidence intervals were 0.80 (0.72, 0.89), 0.71 (0.59, 0.82), and 0.76 (0.71, 0.82) for neurodegenerative diseases; 0.88 (0.74, 1.02), 0.81 (0.50, 1.12), and 0.94 (0.92, 0.96) for ICH; and 0.97 (0.92, 1.03), 0.99 (0.96, 1.01), and 0.99 (0.97, 1.01) for intracranial masses. No studies reported ultrasound presets. Conclusions TCU has a reasonable sensitivity and specificity for detecting intracranial pathology involving ICH and tumors with clinical applications in remote locations or where standard imaging is unavailable. Future studies should investigate ultrasound parameters to enhance diagnostic accuracy in diagnosing intracranial pathology.

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“…[1][2] Several case reports in neurocritical care literature have suggested the use of transcranial ultrasound to monitor postoperative subdural collections and midline shift after hemicraniectomy. [3][4][5][6] A positive correlation between computed tomography (CT) scans and transcranial ultrasound in assessing volumes of hyperdense lesions such as acute hemorrhage is reported in a number of small studies; this correlation is particularly good in the first 4-7 days from onset of hemorrhage. [7][8][9] However, no literature to date has cited use of point-of-care ultrasound (POCUS) by emergency medicine clinicians during initial evaluation of the patient using a craniectomy site for visualization of suspected hemorrhage.…”

Section: Introductionmentioning

confidence: 99%

Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound

et al. 2021

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Intracranial epidural hematoma follow-up using bidimensional ultrasound

Cited by 9 publications

References 3 publications

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

Transcranial ultrasonography to detect intracranial pathology: A systematic review and meta‐analysis

Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound

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