Cheong Issac, Tamagnone Francisco Marcelo
Department of Critical Care Medicine Sanatorio De los Arcos Buenos Aires C1424FSD Argentina.
Argentinian Critical Care Ultrasonography Association (ASARUC) Buenos Aires C1424FSD Argentina.
Australas J Ultrasound Med. 2024 Jun 25;27(4):259-262. doi: 10.1002/ajum.12400. eCollection 2024 Nov.
Intracranial epidural abscesses require swift diagnosis and treatment. While magnetic resonance imaging (MRI) is preferred for its detailed visualisation, it is costly and time-consuming. Transcranial sonography offers a rapid, portable and cost-effective alternative for assessing brain lesions.
We present a case study involving the diagnosis and management of an intracranial epidural abscess in a 25-year-old man with a traumatic brain injury who underwent a craniectomy and later developed fever and drowsiness in the intensive care unit.
Using transcranial point-of-care ultrasound, a hypoechoic collection was identified at the surgical site, prompting further imaging with computed tomography (CT) and MRI, which confirmed the diagnosis of an epidural abscess. Prompt surgical intervention led to the resolution of symptoms and a favourable clinical outcome.
This case highlights the potential utility of brain sonography as an efficient and cost-effective initial diagnostic tool for detecting intracranial complications, particularly in postoperative patients with altered sensorium and fever, where timely intervention is crucial.
颅内硬膜外脓肿需要迅速诊断和治疗。虽然磁共振成像(MRI)因其详细的可视化效果而更受青睐,但它成本高且耗时。经颅超声检查为评估脑损伤提供了一种快速、便携且经济高效的替代方法。
我们展示了一个病例研究,该病例涉及一名25岁的颅脑外伤男性患者,他接受了颅骨切除术,随后在重症监护病房出现发热和嗜睡症状,对其颅内硬膜外脓肿进行诊断和治疗。
使用经颅床旁超声,在手术部位发现了一个低回声区,促使进一步进行计算机断层扫描(CT)和MRI成像,结果证实为硬膜外脓肿。及时的手术干预使症状得到缓解,并取得了良好的临床结果。
该病例突出了脑超声作为一种高效且经济的初始诊断工具在检测颅内并发症方面的潜在效用,特别是对于术后出现意识改变和发热的患者,及时干预至关重要。