Department of Neurosurgery, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany.
Division of Neuroradiology, Department of Radiology, University of Witten/Herdecke, Cologne Merheim Medical Center (CMMC), 51109 Cologne, Germany.
Medicina (Kaunas). 2020 Feb 19;56(2):85. doi: 10.3390/medicina56020085.
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.
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).
Repeated measurements of all four ventricle diameters showed high correlation between CCT and SDT (right lateral r = 0.997, < 0.001; left lateral r = 0.997, < 0.001; third r = 0.991, < 0.001, fourth ventricle r = 0.977, < 0.001). SDT performed well in visualizing basal cerebral arteries including pathologies (e.g., vasospasms) as compared to DSA.
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.
床边超声双功能技术（SDT）可作为开颅去骨瓣减压术（DC）后颅脑计算机断层扫描（CCT）的辅助手段，用于监测颅脑损伤患者。本研究旨在通过比较两种技术，评估 SDT 在 DC 后患者脑室尺寸重复测量中的价值。
回顾性评估 20 例因蛛网膜下腔出血（SAH）、出血和创伤导致颅内压（ICP）升高而行 DC 治疗的患者，这些患者在常规临床实践中接受 SDT 和 CCT 检查。只要临床需要重复 CCT，就在 24 小时内进行 SDT 检查，并通过测量所有四个脑室内径进行相关性分析。还与选定的数字减影血管造影（DSA）比较评估基底脑动脉，包括血管痉挛等病变。
所有四个脑室直径的重复测量均显示 CCT 和 SDT 之间具有高度相关性（右侧侧脑室 r = 0.997， < 0.001；左侧侧脑室 r = 0.997， < 0.001；第三脑室 r = 0.991， < 0.001，第四脑室 r = 0.977， < 0.001）。与 DSA 相比，SDT 可很好地显示基底脑动脉，包括病变（如血管痉挛）。
DC 后难治性 ICP 升高患者的 SDT 对所有四个脑室的重复测量可提供与 CCT 相当的可重复结果。SDT 可作为 DC 后患者有价值的床边监测工具。
