Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study.
In: Indian Journal of Critical Care Medicine, Jg. 28 (2024-03-01), Heft 3, S. 299-306
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Zugriff:
Background: The main objective is to detect clinically significant conditions by transcranial ultrasound (TCS) in post-decompressive craniectomy (DC) patients who come to the emergency department. Materials and methods: This was a cross-sectional observational study. We studied 40 post-DC patients. After primary stabilization, TCS was done. Computer tomography of head was done within 2 hours of performing TCS. The correlation between both modalities were assessed by the measurement of lateral ventricle (LV) (Bland-Altman plot), Midline shift and mass lesion. Additionally, normal cerebral anatomy, 3rd and 4th ventricles and external ventricular drainage (EVD) catheter visualization were also done. Results: About 14/40 patients came with non-neurosurgical complaints and 26/40 patients came with neurosurgical complaints. Patients with non-neurosurgical complaints (4/14) had mass lesions and 1/14 had MLS. Patients with neurosurgical complaints (11/26) had mass lesions and about 5 patients had MLS. A good correlation was found between TCS and CT of head in measuring LV right (CT head = 17.4 ± 13.8 mm and TCS = 17.1 ± 14.8 mm. The mean difference (95% CI) = [0.28 (--1.9 to 1.33), ICC 0.93 (0.88--0.96)], Left [CT head = 17.8 ± 14.4 mm and TCS = 17.1 ± 14.2 mm, the mean difference (95% CI) 0.63 (--1.8 to 0.61), ICC 0.96 (0.93--0.98)], MLS [CT head = 6.16 ± 3.59 (n = 7) and TCS = 7.883 ± 4.17 (n = 6)] and mass lesions (kappa 0.84 [0.72--0.89] [95% CI] p-value < 0.001). The agreement between both modalities for detecting mass lesions is 93.75%. Conclusion: Point of care ultrasound (POCUS) is a bedside, easily operable, non-radiation hazard and dynamic imaging tool that can be used for TCS as a supplement to CT head in post-DC patients in emergency as well as in ICU. However, assessment of the ventricular system (pre/post-EVD insertion), monitoring of regression/progression of mass lesion, etc. can be done with TCS. Repeated scans are possible in less time which can decrease the frequency of CT head. [ABSTRACT FROM AUTHOR]
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Titel: |
Correlation between Transcranial Ultrasound and CT Head to Detect Clinically Significant Conditions in Post-craniectomy Patients Performed by Emergency Physician: A Pilot Study.
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Autor/in / Beteiligte Person: | Chouhan, Rahul ; Sinha, Tej P. ; Bhoi, Sanjeev ; Kumar, Atin ; Agrawal, Deepak ; Nayer, Jamshed ; Pandey, Ravindra M. ; Aggarwal, Praveen ; Ekka, Meera ; Mishra, Prakash R. ; Kumar, Akshay ; Chouhan, Divya C. |
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Zeitschrift: | Indian Journal of Critical Care Medicine, Jg. 28 (2024-03-01), Heft 3, S. 299-306 |
Veröffentlichung: | 2024 |
Medientyp: | academicJournal |
ISSN: | 0972-5229 (print) |
DOI: | 10.5005/jp-journals-10071-24662 |
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