Transcranial ultrasound diagnosis of intracranial lesions in children with headaches

Wang, Huei-Shyong; Kuo, Meng-Fai; Huang, Song‐Chei; Chou, Ming-Liang; Hung, Po-Chen; Lin, Kuang-Lin

doi:10.1016/s0887-8994(01)00372-1

Cited by 11 publications

(14 citation statements)

References 18 publications

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“…18 The addition of TCD technology to ultrasonographic examination made it possible to conduct studies in children after fontanelle closure, by applying the transducer to the temporal region. 20,25,28,36 The use of TCD allows one to obtain real-time measurements of arterial or venous blood flow velocity directly from insonation of vessels coded in color or by methodically searching the vessels and analyzing changes in sound frequencies. 2,5 Although direct measurement of the ICP remains the gold standard for determining the adequacy of ventricular decompression at any particular moment, such procedures are invasive.…”

Section: Discussionmentioning

confidence: 99%

Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus

Oliveira¹,

Machado²

2003

FOC

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Object Hydrocephalus is a common disease process. Transcranial color-coded Doppler (TCCD) ultrasonography is an accepted noninvasive method with which to quantify intracranial blood flow in adults and children. The authors studied the applications of TCCD ultrasonography and the alterations of the flow velocity of the cerebral arteries in children with hydrocephalus. Methods One hundred thirty-five children were divided into three groups: Group 1 comprised 40 infants with asymptomatic hydrocephalus who had well-functioning ventriculoperitoneal (VP) shunts; Group 2 comprised 10 children with symptomatic hydrocephalus who had malfunctioning shunts that were replaced; and Group 3 was a control group of 85 healthy infants. All patients underwent sequential measurements of cerebral blood flow (CBF) velocities (systolic and diastolic velocities) and resistivity index (RI). One group of patients underwent functional tests (compression of the anterior fontanelle and CO2 vasoreactivity) to determine hemodynamic changes in cerebral circulation. A significant statistical change in RI measurements, end diastolic CBF velocity, and percentage of change in RI was shown in patients with malfunctioning shunts, and in infants with a well-functioning VP shunt vasomotor reactivity was severely reduced. Conclusions Transcranial color-coded Doppler ultrasonography can be used to perform follow-up assessments of normal and malfunctioning shunts in children with hydrocephalus; the functional tests are a noninvasive tool for evaluating the cerebral compliance and the cerebral autoregulation in infants with hydrocephalus. The autoregulatory capacity may partly or completely be lost in cases of long-term shunt-treated hydrocephalus, and loss of cerebral vasoreactivity may be responsible for long-term deficits commonly observed in children, which help explain some of symptoms related to slit ventricles.

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Section: Discussionmentioning

confidence: 99%

Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus

Oliveira¹,

Machado²

2003

FOC

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“…Since then, the middle cerebral artery PSV has been the standard of care for treatment of anemic fetuses. Doppler studies have also been used in neonates with different cerebral conditions (eg, intraventricular hemorrhage, brain lesions, and hydrocephalus) 3 – 6 . However, this approach has not been attempted in neonates suspected to have blood volume disorders such as anemia and polycythemia.…”

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confidence: 99%

Doppler Middle Cerebral Artery Peak Systolic Velocity for Diagnosis of Neonatal Anemia

Weissman

Olanovski

Weiner

et al. 2012

Journal of Ultrasound in Medicine

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ore than a decade ago, Mari et al 1,2 achieved a major breakthrough in the treatment of Rh-sensitized fetuses with their pioneering work that showed a correlation between the Doppler middle cerebral artery peak systolic velocity (PSV) and fetal hemoglobin levels. This technique has virtually eliminated the need for invasive procedures such as amniocentesis and cordocentesis that have been used for diagnosis of fetal anemia with their inherent complications. Since then, the middle cerebral artery PSV has been the standard of care for treatment of anemic fetuses. Doppler studies have also been used in neonates with different cerebral conditions (eg, intraventricular hemorrhage, brain lesions, and hydrocephalus). [3][4][5][6] However, this approach has not been attempted in neonates suspected to have blood volume disorders such as anemia and polycythemia. If a correlation between neonatal hemoglobin levels and the middle cerebral artery PSV is found, it may be Amir Weissman, MD, Irena Olanovski, MD, Zeev Weiner, MD, Shraga Blazer, MD Received January 13, 2012, ORIGINAL RESEARCHObjectives-The peak systolic velocity (PSV) of the middle cerebral artery was found to be predictive of fetal anemia and is routinely applied in the treatment of such fetuses. Our objective was to determine whether a correlation exists between the PSV in the neonatal middle cerebral artery and hemoglobin levels for possible future implementation in clinical practice.Methods-A prospective study on 151 neonates was conducted, examining their middle cerebral artery PSV concomitantly with their hemoglobin level during the first 36 hours after delivery. The study population included 122 normocythemic, 24 anemic, and 5 polycythemic neonates. An analysis of variance between normocythemic, anemic, and polycythemic neonates was performed, and a regression analysis of the PSV versus hemoglobin levels was conducted.Results-The normocythemic neonates had a mean middle cerebral artery PSV ± SD of 41.3 ± 11.4 cm/s, whereas the anemic neonates had a significantly higher PSV (63.8 ± 28.5 cm/s), and the polycythemic neonates had a significantly lower PSV (26.8 ± 7.4 cm/s; P < .001). A statistically significant correlation was found between hemoglobin levels and the middle cerebral artery PSV (P < .01).Conclusions-Neonatal anemia and polycythemia can be rapidly diagnosed at the bedside by examining the middle cerebral artery PSV. This technique can be used as an ancillary measure to promptly diagnose acute neonatal blood volume changes for an immediate intervention.

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“…The visualization of intracranial anatomy on B-mode ultrasound is challenging due to the presence of the skull, but thin parts of the temporal bone allow transcranial insonation of the brain in a majority Multiple prior studies have compared the sensitivity of cranial ultrasound in assessing hemorrhage, 23,25,26,[36][37][38][39][40][41][42][43][44][45][46][47][48] stroke, 25 or tumor. 44,[52][53][54][55] However, there is no standard reference resource for cranial topography to outline the appearance of normal and abnormal structures of the brain on B-mode imaging. We provide a descriptive review of the topography of the normal and abnormal brain with illustrative images of different structures visible on B-mode cranial ultrasound in the critically ill population.…”

Section: Discussionmentioning

confidence: 99%

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

Kapoor

Offnick

Allen

et al. 2022

Journal of Neuroimaging

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Background and Purpose Many studies have explored the possibility of using cranial ultrasound for discerning intracranial pathologies like tumors, hemorrhagic stroke, or subdural hemorrhage in clinical scenarios where computer tomography may not be accessible or feasible. The visualization of intracranial anatomy on B‐mode ultrasound is challenging due to the presence of the skull that limits insonation to a few segments on the temporal bone that are thin enough to allow transcranial transmission of sound. Several artifacts are produced by hyperechoic signals inherent in brain and skull anatomy when images are created using temporal windows. Methods While the literature has investigated the accuracy of diagnosis of intracranial pathology with ultrasound, we lack a reference source for images acquired on cranial topography on B‐mode ultrasound to illustrate the appearance of normal and abnormal structures of the brain and skull. Two investigators underwent hands‐on training in Cranial point‐of‐care ultrasound (c‐POCUS) and acquired multiple images from each patient to obtain the most in‐depth images of brain to investigate all visible anatomical structures and pathology within 24 hours of any CT/MRI imaging done. Results Most reproducible structures visible on c‐POCUS included bony parts and parenchymal structures. Transcranial and abdominal presets were equivalent in elucidating anatomical structures. Brain pathology like parenchymal hemorrhage, cerebral edema, and hydrocephalus were also visualized. Conclusions We present an illustrated anatomical atlas of cranial ultrasound B‐mode images acquired in various pathologies in a critical care environment and compare our findings with published literature by performing a scoping review of literature on the subject.

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Transcranial ultrasound diagnosis of intracranial lesions in children with headaches

Cited by 11 publications

References 18 publications

Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus

Transcranial color-coded Doppler ultrasonography for evaluation of children with hydrocephalus

Doppler Middle Cerebral Artery Peak Systolic Velocity for Diagnosis of Neonatal Anemia

Brain topography on adult ultrasound images: Techniques, interpretation, and image library

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