Abstract
Objective
To explore the feasibility and reliability of B-mode ultrasound for assessment of intracranial lesions in multiple trauma patients who had undergone craniectomy.
Design
ingle-centre study.
Setting
A 16-bed emergency intensive care unit (ICU) in the emergency department of 2nd Affiliated Hospital of Zhejiang University School of Medicine from July 2006 to June 2010.
Methods
We retrospectively analysed 13 multiple trauma patients with severe head injury admitted to the emergency department of 2nd Affiliated Hospital of Zhejiang University School of Medicine. All 13 patients were admitted to the ICU after craniectomy and received mechanical ventilation. Computed tomography (CT) were conducted when patients' consciousness, pupillary size, light reflex changed apparently, or if the bone window tension and the intracranial pressure increased unexpectedly. Head ultrasonography was performed within 2 hours of CT scanning.
Results
Ultrasonography revealed 18 pathological changes in the 13 patients. CT and a second operation helped to identify 23 pathological changes. The results of B-mode ultrasound were compared with those of CT and the coincidence rate was 78.3%, with no significant difference in the diagnosis of delayed haematoma or midline shift (Kappa=0.898, p<0.05).
Conclusions
Transcranial ultrasonography may be a useful tool for monitoring post-operation intracranial lesions in multiple trauma patients with severe head injury. It is an effective supplement to CT.