Rapid detection of recurrent intraventricular hemorrhage by ultrasound in a multiple trauma patient who had undergone craniectomy
© BioMed Central Ltd 2012
Published: 8 November 2012
Ultrasound may be a useful tool to evaluate intracranial abnormalities in critically ill patients undergoing decompressive craniectomy. We present a multiple trauma patient who had undergone craniectomy and in whom recurrent intraventricular hemorrhage and patterns of cerebral blood flow were rapidly detected by ultrasound.
Ultrasound has been widely used for rapid assessment of critical illness and is regarded as a visual stethoscope. There are few reports on the diagnosis of intracranial lesions by ultrasound in ICU patients. Here we present a multiple trauma patient who had undergone craniectomy and in whom recurrent intraventricular hemorrhage was rapidly detected by ultrasound.
Ultrasound is a useful tool to evaluate intracranial abnormalities in patients undergoing decompressive craniectomy. The absence of the skull may facilitate the ultrasound to detect the brain, and intracranial morphological abnormal signs such as dislocation of the midline, intracerebral hematomas, size of lateral ventricular and hydrocephalus may be clearly displayed on the screen [1, 2]. This rapid and non-invasive method can complement the results of CT and may help to reduce delays in surgical management. Caricato and colleagues  found that ultrasound in patients with decompressive craniectomy was as effective as CT to evaluate intracerebral disorders. In this multiple trauma patient, IVH happened twice after the craniectomy and was immediately identified by ultrasound. Meanwhile, ultrasound may detect the characteristics of cerebral blood flow, which helps to assess intracranial pressure and cerebral perfusion pressure [4, 5]. This highlights the special value of transcranial ultrasound in critically ill patients with craniectomy.
Glascow Coma Score
Written consent for publication was obtained from the patient's next of kin.
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