Korean J Neurotrauma.  2017 Oct;13(2):137-140. 10.13004/kjnt.2017.13.2.137.

Intraoperative Transcranial Sonography for Detection of Contralateral Hematoma Volume Change in Patients with Traumatic Brain Injury

• Kim PS
• Yu SH
• Lee JH
• Choi HJ
• Kim BC

• KMID: 2394548
• DOI: http://doi.org/10.13004/kjnt.2017.13.2.137

Abstract

The authors present two clinical cases, in which intraoperative transcranial sonography (TCS) was used to detect a change in contralateral hematoma volume. A 51-year-old female and a 5-year-old male underwent osteoplastic craniotomy for epidural hematoma removal. Scant contralateral hematoma was evident by preoperative computed tomography in both patients. Intraoperative TCS was used to detect changes in contralateral hematomas. After observing a volume change in one case, a second operation was performed immediately. Based in this experience, the authors recommend intraoperative TCS for the detection of contralateral hematoma volume changes.

Keyword

Brain injuries, traumatic; Intracranial pressure; Ultrasonography

MeSH Terms

Brain Injuries*
Child, Preschool
Craniotomy
Female
Hematoma*
Humans
Intracranial Pressure
Male
Middle Aged
Ultrasonography

Figure

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  FIGURE 1 A 5-year-old man admitted after a fall from a height of 2 m. The initial computed tomography scan showed an epidural hematoma on right temporoparietal area and subdural hematoma on the contralateral side.

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  FIGURE 2 (A) Intraoperative transcranial sonography (TCS) was performed. (B) After evacuation of the right temporoparietal hematoma, intraoperative TCS showed no changed subdural hematoma (asterisk) on the contralateral side. (C) Postoperative computed tomography confirmed an unchanged subdural hematoma status on the contralateral side.

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  FIGURE 3 A 51-year-old female admitted after a pedestrian accident. Initial computed tomography scan showed an epidural hematoma on the right temporoparietal area and subdural hematoma on the left frontotemporal area.

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  FIGURE 4 (A) After evacuation of right temporoparietal hematoma, intraoperative transcranial sonography showed a newly developed epidural hematoma (EDH) (asterisk) on the left frontal area. (B) Postoperative computed tomography confirmed newly developed EDH on the left frontal area. (C) EDH on the left frontal area was evacuated by secondary operation.

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