Document Detail

Transcranial colour-coded sonography for the bedside evaluation of mass effect after stroke.
MedLine Citation:
PMID:  11136349     Owner:  NLM     Status:  MEDLINE    
Repeated cranial computerized tomography scan examination in patients with elevated intracranial pressure is time consuming and requires patient transportation. We prospectively evaluated the diagnostic value of transcranial duplex sonography as a bedside tool for detection of the mass effect after space-occupying ischemic stroke and brain haemorrhage and for evaluating the width and dislocation of the ventricular system and the dislocation of brain mid-line structures. We used transcranial duplex sonography in 21 consecutive patients with space-occupying ischemic middle cerebral artery infarction and brain haemorrhage. The transcranial duplex sonography examinations were performed within 2 h before or after corresponding follow-up cranial computerized tomography scans. We measured the third ventricular width as a parameter for infratentorial and the mid-line shift for supratentorial space-occupying effect. In all patients, mid-line structures could be identified by transcranial duplex sonography. Significant third ventricular dilation was found subsequently in most patients with infratentorial mass effect, and mid-line shift occurred in all patients with supratentorial space-occupying lesions, respectively. The mean difference (absolute values) between transcranial duplex sonography and cranial computerized tomography measurements was 0.8 mm for the ventricular width (standard deviation 1 mm) and 1.1 mm for the mid-line shift (standard deviation: 1.46 mm), with a tendency for these parameters to be underestimated at higher values using transcranial duplex sonography. The linear correlation coefficients were R = 0.97 and R = 0.94, respectively. Transcranial duplex sonography appears to be a sufficiently reliable bedside method for evaluating the width and the lateral displacement of the third ventricle, as validated by cranial computerized tomography scan. Thus, it may be suitable for monitoring the space-occupying effect of both supra- and infratentorial strokes during treatment on critical care and stroke units.
M Bertram; W Khoja; P Ringleb; S Schwab
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of neurology : the official journal of the European Federation of Neurological Societies     Volume:  7     ISSN:  1351-5101     ISO Abbreviation:  Eur. J. Neurol.     Publication Date:  2000 Nov 
Date Detail:
Created Date:  2001-02-08     Completed Date:  2001-02-08     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9506311     Medline TA:  Eur J Neurol     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  639-46     Citation Subset:  IM    
Department of Neurology, University of Heidelberg INF 400, Heidelberg 69120, Germany.
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MeSH Terms
Cerebral Hemorrhage / radiography,  ultrasonography*
Cerebral Infarction / radiography,  ultrasonography*
Middle Aged
Middle Cerebral Artery
Point-of-Care Systems
Regression Analysis
Reproducibility of Results
Stroke / radiography,  ultrasonography*
Tomography, X-Ray Computed
Ultrasonography, Doppler, Color
Ultrasonography, Doppler, Transcranial*

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