gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

Brain parenchyma sonography to evaluate ventricle width in critical care patients with cerebrospinal fluid circulation disturbance

Meeting Abstract

  • A. Becker - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • D. Kuhnt - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • J. Rohlfs - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • L. Benes - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg
  • C. Nimsky - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 108

DOI: 10.3205/12dgnc494, URN: urn:nbn:de:0183-12dgnc4947

Published: June 4, 2012

© 2012 Becker et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.


Outline

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Objective: Ventricular catheterization with external ventricular drainage (EVD) is a commonly used neurosurgical procedure for treatment of acute cerebrospinal fluid circulation disturbances. The most frequent reasons for EVD application are intracranial or subarachnoidal hemorrhages, pre-surgical treatment of acute space occupying lesions or severe head injuries. In this study, we investigate the use of brain parenchyma sonography to demonstrate the width of the ventricle system in patients with EVD. For this purpose we compare bedside ultrasound (US) ventricle size with computed tomography (CT) scans.

Methods: Sonography was performed in ten patients with EVD. US was emitted using a Siemens Acuson X 300 with a 2.5 MHz phased array transducer through a temporal bone window in axial plane. Penetration depth was 15 cm with a dynamic range of 65 dB. US images of the mesencephalic-, diencephalic- and the cella media plane were stored in DICOM format and measured offline by using OsiriX Version 3.9.2. Anterior horns in the diencephalic plane and the lateral ventricle in the cella media plane were measured from the contralateral temporal windows. CT was performed with a Siemens Somatom Definition less than one hour after US. A Wilcoxon-Test was used to compare the values.

Results: Ten patients (6 male, 4 female, mean age 52 years) were examined. The mean value of the third ventricle width was 0.68 (standard deviation 0.4) in US and 0.73 (0.43) in native CT (p=0.11). Fourth ventricle width was 0.94 (0.3) in US and 1.04 in CT scan (p=0.06). The mean US values for the lateral horns were 2.36 (0.6) on the right and 2.32 on the left site. In the CT scans the mean width of the lateral horns was 2.13 (0.6) on the right and 2.29 (0.6) on the left side with p=0.13 and p=0.31, respectively. The mean width of the right lateral ventricle was 1.5 (0.56) in US and 1.43 (0.5) in CT (p=0.87). For the left lateral ventricle the mean US value was 1.45 (0.53) and 1.36 (0.5) in CT (p=0.4). The mean duration for US examination counted 03:17 minutes.

Conclusions: Brain parenchyma sonography is a valid, time saving, safe and arbitrarily repeatable method to evaluate ventricle width in patients with EVD. For critically ill patients, it is a feasible method, which does not require patient transportation or severe mobilization. Therefore, future studies should evaluate, if bedside US can replace CT scans for routine follow-up examination of ventricle size.