Cerebral Ventricular Dimensions After Decompressive Craniectomy: A Comparison Between Bedside Sonographic Duplex Technique and Cranial Computed Tomography

Bendella, Habib; Maegele, Marc; Hartmann, A.; Spreer, Joachim; Rommel, Nadine; Lefering, Rolf; Nakamura, Makoto; Igressa, Alhadi

doi:10.1007/s12028-016-0359-2

Cited by 21 publications

(17 citation statements)

References 27 publications

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“…First attempts in this direction were published in 1983 and 1989, while more recent studies provide significant evidences in favor of TCS in craniectomized patients, especially during the ICU patient management. [8][9][10][11][12][13][14] At least one early surgical postoperative complication (brain parenchyma contusions, hematomas, midline shifts, and ventricular enlargements) can occur in about 70% of craniectomized patients, the most frequent being a development of an extra-axial fluid collection (about 30%). 15 The main aim of this study is to analyze the agreement between TCS and CT scan in diagnosing intercurrent complications in craniectomized patients.…”

Section: Introductionmentioning

confidence: 99%

Transcranial Sonography versus CT for Postoperative Monitoring After Decompressive Craniectomy

Bonis

Mantovani

Lofrese

et al. 2020

Journal of Neuroimaging

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Computed tomography (CT) is the actual gold standard diagnostic tool for monitoring patients after decompressive craniectomy. It is validated and provides a wide number of information. However, it takes time, expensive, and requires patient transportation. Transcranial sonography (TCS) could represent an alternative diagnostic tool in these patients. The aim of this study is to compare TCS versus CT scan after decompressive craniectomy in terms of diagnosing complications and costs evaluation. METHODS: We prospectively enrolled 10 craniectomized patients who were monitored with sonography and CT. Ventricular measurements and possible complications were evaluated by two independent observers. The two methods were compared using Fisher's exact test and Spearman's Rho coefficient. A costs analysis was also conducted. RESULTS: A good correlation coefficient (ρ) between CT and TCS was found for frontal horn dimensions (ρ .9929), median cella (ρ .9516), and third ventricle (ρ .8989). All results were statistically significant (P < .0001) and Bland-Altman plots showed no systemic biases. Fisher's exact test showed no statistically significant differences between TCS and CT for all the studied predefined complications. Cost analysis showed a 68% cost reduction in favor of TCS. CONCLUSIONS: TCS could be a reliable alternative diagnostic tool for major complications in patients undergoing decompressive craniectomy. It could limit the number of CT scans per patient overcoming several limitations, such as costs, radiation exposure, and need to move the patient.

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Section: Introductionmentioning

confidence: 99%

Transcranial Sonography versus CT for Postoperative Monitoring After Decompressive Craniectomy

Bonis

Mantovani

Lofrese

et al. 2020

Journal of Neuroimaging

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“…A bedside monitoring method for follow-up during further neurocritical care after DC on the ICU is thus desirable. As shown recently, bedside SDT may have the potential to serve as an adjunct to CCT in the assessment of ventricular dimensions with a high correlation to the "gold standard" [10][11][12]19]. In the present study, serial quantitative measurements of all four ventricle dimensions in identical patients after DC via SDT were compared to CCT with intraclass correlation coefficients ranging between 0.977 and 0.997 for all three measurements over time.…”

Section: Discussionmentioning

confidence: 68%

“…Further development of the technology led to the clinical application of SDT, which allowed the correct spatial imaging of intracranial arteries [23,24]. As previously shown, SDT as a bedside tool may be considered as a reliable method and tool for the identification and differentiation of specific brain structures including pathologies, such as hematomas, midline shifts, ventricular enlargements as well as probe or drain positioning [10][11][12].…”

Section: Discussionmentioning

confidence: 99%

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Bedside Sonographic Duplex Technique as a Monitoring Tool in Patients after Decompressive Craniectomy: A Single Centre Experience

et al. 2020

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Background and objectives: Bedside sonographic duplex technique (SDT) may be used as an adjunct to cranial computed tomography (CCT) to monitor brain-injured patients after decompressive craniectomy (DC). The present study aimed to assess the value of SDT in repeated measurements of ventricle dimensions in patients after DC by comparing both techniques. Materials and Methods: Retrospective assessment of 20 consecutive patients after DC for refractory intracranial pressure (ICP) increase following subarachnoid hemorrhage (SAH), bleeding and trauma which were examined by SDT and CCT in the context of routine clinical practice. Whenever a repeated CCT was clinically indicated SDT examinations were performed within 24 hours and correlated via measurement of the dimensions of all four cerebral ventricles. Basal cerebral arteries including pathologies such as vasospasms were also evaluated in comparison to selected digital subtraction angiography (DSA). Results: Repeated measurements of all four ventricle diameters showed high correlation between CCT and SDT (right lateral r = 0.997, p < 0.001; left lateral r = 0.997, p < 0.001; third r = 0.991, p < 0.001, fourth ventricle r = 0.977, p < 0.001). SDT performed well in visualizing basal cerebral arteries including pathologies (e.g., vasospasms) as compared to DSA. Conclusions: Repeated SDT measurements of the dimensions of all four ventricles in patients after DC for refractory ICP increase delivered reproducible results comparable to CCT. SDT may be considered as a valuable bedside monitoring tool in patients after DC.

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“…In this issue of Neurocritical Care, Bendella et al [6] evaluated in their prospective study the ventricular diameters of all ventricles in patients after decompressive craniectomy by sonographic duplex technique versus CT. A total of 102 consecutive patients underwent decompressive craniectomy because of increased intracranial pressure after cerebral ischemia, ICH or traumatic brain injury. Ultrasound was performed no later than 24 h after cranial imaging, and equally important the examiner was blinded to the results of the CT.…”

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confidence: 99%

Bedside Ultrasound After Decompressive Craniectomy: A New Standard?

2017

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Cerebral Ventricular Dimensions After Decompressive Craniectomy: A Comparison Between Bedside Sonographic Duplex Technique and Cranial Computed Tomography

Cited by 21 publications

References 27 publications

Transcranial Sonography versus CT for Postoperative Monitoring After Decompressive Craniectomy

Transcranial Sonography versus CT for Postoperative Monitoring After Decompressive Craniectomy

Bedside Sonographic Duplex Technique as a Monitoring Tool in Patients after Decompressive Craniectomy: A Single Centre Experience

Bedside Ultrasound After Decompressive Craniectomy: A New Standard?

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