Comparison of transcranial color-coded duplex sonography and cranial CT measurements for determining third ventricle midline shift in space-occupying stroke.
OBJECTIVE
Transcranial color-coded duplex sonography (TCCS) allows the noninvasive, easily reproducible measurement of midline dislocation (MLD) of the third ventricle in space-occupying stroke, even in critically ill patients. However, the method has been validated only in a small number of subjects. The aim of this study was to test the method under clinical conditions.


METHODS
In 61 prospectively recruited patients (mean age, 62+/-15 years) with supratentorial ischemic infarction or intracranial hemorrhage, the sonographic measurement of MLD was compared with cranial CT data in a 12-hour time window. Subgroup analysis was also undertaken for comparing TCCS and cranial CT measurements within a 3-hour time window.


RESULTS
One hundred twenty-two data pairs of TCCS and cranial CT MLD measurements were correlated within the 12-hour time window. TCCS and cranial CT measurements of MLD correlated both in the total patient group and in the different subgroups with coefficients of over 0.9. The 2-SD confidence interval of the difference between the TCCS measurements and the respective means of both methods in the total patient collective was +/-1.78 mm.


CONCLUSIONS
TCCS provides a noninvasive, easily reproducible and reliable method for monitoring MLD of the third ventricle in stroke patients. It is particularly suitable for critically ill patients who are not fit for transportation.
Stolz
E
E
Department of Neurology, University of Giessen, Germany.
Gerriets
T
T
Fiss
I
I
Babacan
S S
SS
Seidel
G
G
Kaps
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003422:Critical Care; D005260:Female; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis*; D020300:Intracranial Hemorrhages / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D020542:Third Ventricle / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial