Sonographic monitoring of midline shift in hemispheric infarctions

Gerriets, Tibo; Stolz, Erwin; Modrau, Boris; Fiss, Ingo; Seidel, Günter; Kaps, Manfred

doi:10.1212/wnl.52.1.45

Cited by 83 publications

(56 citation statements)

References 35 publications

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“…Results of evaluation of the third ventricle, at an insonation angle of 80 to 90°, are superior to those of the lateral ventricle, and the technique allows for the estimation of a potential midline shift with great accuracy in cases such as those with space-occupying hemispheric infarction. [2,12] In 1994, dTCS was used to assess raised ICP. In a study of 26 patients, Becker, et al, [2] found undulating septa pellucida and CSF pressures below 25 cm H 2 O.…”

Section: Discussionmentioning

confidence: 99%

Dynamic and three-dimensional transcranial sonography studies of an asymptomatic, cerebral convexity arachnoid cyst

Schlachetzki¹,

Hölscher²,

Ullrich³

et al. 1999

FOC

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Dynamic and three-dimensional transcranial sonography (dTCS and 3D-TCCS) examinations are complementary, noninvasive methods used in the assessment and follow up of patients with cerebrospinal fluid (CSF) circulation disorders.A 16-year-old female patient who presented with a space-occupying, cerebral convexity arachnoid cyst and recurrent tension-type headache underwent examination for raised intracranial pressure (ICP) by using a standard color-coded duplex sonography system attached to a personal computer--based system for 3D data acquisition. Conventional TCS identified the outer arachnoid membrane of the cyst, which undulated freely after short rotation of the head ("headshake maneuver"). The undulation was documented as a QuickTime movie that is included with this article. A 3D dataset was acquired and, by using a multiplanar reformatting reconstruction algorithm, the authors obtained images with excellent resolution that corresponded to an initial magnetic resonance (MR) imaging study. No differences on dTCS and 3D-TCS were detectable at follow up 9 months later, indicating normal ICP and a stable, benign condition.The use of 3D-TCCS and dTCS ultrasonography may complement other diagnostic procedures such as MR imaging and, thus, can improve management and therapeutic strategies for patients with CSF circulation disorders. In this report the authors present evidence of the excellent fine resolution and exact reproducibility of reconstructed ultrasound image planes derived from 3D datasets and the additional biomedical information from dynamic imaging.

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Section: Discussionmentioning

confidence: 99%

Dynamic and three-dimensional transcranial sonography studies of an asymptomatic, cerebral convexity arachnoid cyst

Schlachetzki¹,

Hölscher²,

Ullrich³

et al. 1999

FOC

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“…During B-mode imaging, the diameter of the third ventricle was measured from both sides. A midline shift (MLS) was calculated by measuring the distance from the transducer to the center of the third ventricle on both left (distance A) and right (distance B) sides, and then dividing the resulting number in half (MLS = (A -B)/2) [20]). The examination was performed at the patient's bedside using a CX50 system (Philips, Bothell, WA, USA) for transcranial imaging and a CV70 unit (Siemens, Erlangen, Germany) for extracranial sonography.…”

Section: Inclusion Criteriamentioning

confidence: 99%

Influence of Positive End-Expiratory Pressure Ventilation on Cerebral Perfusion and Cardiac Hemodynamics

Backhaus¹,

Torka²,

Ertl³

et al. 2017

J Depress Anxiety

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“…B-Mod transkranial ultrasonografi ile doğrudan orta-hat şiftinin ölçümü (27)(28)(29)(30)(31), lateral ve üçüncü ventrikül çaplarının ölçülmesi ile hidrosefalinin saptanması, septum pellusidum osilatuar hareketlerindeki değişikliklerin belirlenmesi ve optik sinir kılıf çapının ölçümü ile KİB noninvazif olarak monitörize edilebilir.…”

Section: B-mod Transkrani̇al Sonografi̇unclassified

“…İlk 32 saatte MLS 4-mm ve üzerinde ise transtentorial herniasyon için oldukça sensitif bir belirteç olup hasta başında yapılabilmesi avantajı ile birlikte hem dekompresif kranyektomi zamanlamasında hem de hangi hastanın dekompresyonsuz fatal seyredeceği hakkında bilgi verir (31). Örneğin 42 hastada yapılan bir çalışmada MLS değerinin 16. saatte 2,5 mm; 24. saatte 3,5 mm, 3. saatte 4,0 mm ve 40. saatte 5,0 mm veya daha fazla olmasının fatal sonuçlanım için sensitivitesi ve pozitif prediktif değeri yaklaşık olarak 1 bulunmuştur (27).…”

Section: Orta-hat şIftinin Sonografik öLçümüunclassified

Neurosonology of intracranial pressure increase

Togcuoglu¹,

Arsava²

2011

Türk Beyin Damar Hast Derg

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Nörolojik yoğun bakımlarda kafa içi basıncı yükselmesi sadece sık görülmesinden dolayı değil aynı zamanda tedavi edilebilir olmasından dolayı da önemli bir problemdir. Birçok hastalığın seyrinde kafa içi basıncının doğrudan ölçümü ya da tahmin edilmesinin kritik önemi vardır. Non-invazif ve yatak başında kullanılabilen birçok nörosonolojik yöntem ile kafa içi basıncı monitörize edilebilir. Bu makalede bu yöntemler literatür bilgisi ışığında pratik uygulama temel alınarak gözden geçirilmektedir. Anahtar Sözcükler: Transkranial Doppler, B-mod, pulsatilite, orta hat şifti, orbital sonografi, otoregülasyon. NEUROSONOLOGY OF INTRACRANIAL PRESSURE INCREASE SUMMARYIncrease in intracranial pressure (ICP) is one of the most significant problems in the neurological intensive care units not only due to its high prevalence, but also due to its treatable nature. Direct measurement or indirect estimation of ICP during the course of many neurological diseases is of critical importance. A variety of neurosonogical methodologies, which are totally non invasive and applicable at the bed-side repeatedly, have extensively been used to evaluate and monitor ICP. These neurosonological techniques, including most recent developments, are herein reviewed primarily from the perspective of practical applications.

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Sonographic monitoring of midline shift in hemispheric infarctions

Abstract: The study of MLS at 32 hours after stroke onset in patients with severe MCA infarctions may identify patients who are unlikely to survive. The value of MLS in determining the indication of decompressive craniectomy merits further study.

Cited by 83 publications

References 35 publications

Dynamic and three-dimensional transcranial sonography studies of an asymptomatic, cerebral convexity arachnoid cyst

Dynamic and three-dimensional transcranial sonography studies of an asymptomatic, cerebral convexity arachnoid cyst

Influence of Positive End-Expiratory Pressure Ventilation on Cerebral Perfusion and Cardiac Hemodynamics

Neurosonology of intracranial pressure increase

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