Identification of intracranial hemorrhage progression by transcranial point-of-care ultrasound in a patient with prior hemicraniectomy: a case report
| Autor: | Bradley C. Presley, Cynthia Oliva, Aalap Shah, Ryan M Barnes |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
Adult
Male Intracranial pathology medicine.medical_specialty Point-of-Care Systems Population Case Report Head trauma 03 medical and health sciences 0302 clinical medicine Internal Medicine medicine Humans Radiology Nuclear Medicine and imaging In patient education Aged Ultrasonography education.field_of_study business.industry Point of care ultrasound Ultrasound 030208 emergency & critical care medicine General Medicine Transcranial Doppler Radiology Tomography X-Ray Computed business Intracranial Hemorrhages 030217 neurology & neurosurgery External ventricular drain |
| Zdroj: | J Ultrasound |
| ISSN: | 1876-7931 |
| DOI: | 10.1007/s40477-021-00588-6 |
| Popis: | Transcranial ultrasound has been described as a tool to identify intracranial pathology, however, it is seldom used in the adult patient population due to poor imaging windows and rapid availability of more advanced imaging such as CT and MRI. We report a unique population in which transcranial ultrasound may be beneficial: those with a history of hemicraniectomy. We present a case of a 65-year-old male with a history of hemicraniectomy who suffered head trauma after a fall from his wheelchair. An initial non-contrast head CT scan identified an intracranial hemorrhage. Point-of-care bedside transcranial ultrasound was able to identify the progression of intracranial hemorrhage, which was confirmed by interval head CT. This prompted repeat CT imaging followed by neurosurgical intervention with the placement of an external ventricular drain in the right lateral ventricle. While ultrasound is unlikely to replace the need for more advanced imaging in these patients, point-of-care transcranial ultrasound may be a useful tool that can be employed rapidly at the bedside for interval screening in patients with hemicraniectomy and concern for new or worsening intracranial hemorrhage. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40477-021-00588-6. |
| Databáze: | OpenAIRE |
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