Monitoring midline shift by transcranial color-coded sonography in traumatic brain injury. A comparison with cranial computerized tomography.
OBJECTIVE
Transcranial color-coded duplex sonography (TCCDS) is a non invasive bedside technique that allows the determination of midline shift (MLS). The purpose of our study was to compare MLS measurements using TCCDS with those obtained with cranial computerized tomography (CT) in patients with traumatic brain injury (TBI).


METHODS
Prospective study.


METHODS
Intensive care unit in a university hospital.


METHODS
Forty-one traumatic brain-injured patients (35 men and 6 women).


METHODS
A total of 60 studies were conducted with a time interval between the cranial CT and the TCCDS studies of 322+/-216 min.


RESULTS
The coefficient of correlation between MLS measured by CT and TCCDS was 0.88, the bias was 0.12 mm, the precision was 1.08 mm and the limits of agreement were +2.33 to -2.07 mm. There were no statistically significant differences in MLS measured by the two techniques in terms of: sex, age or type of lesion according to the Traumatic Coma Data Bank classification.


CONCLUSIONS
The TCCDS is a non-invasive bedside technique that is valid for determining MLS in patients with traumatic brain injury. Due to the risks involved in the transportation of traumatic brain-injured patients to the radiology department, this bedside technique is specially interesting in these patients.
Llompart Pou
Juan Antonio
JA
Servicio de Medicina Intensiva y Unidad Coronaria, Hospital Universitario Son Dureta, Palma de Mallorca, Baleares, Spain. ja_llompart@hotmail.com
Abadal Centellas
Josep María
JM
Palmer Sans
Margarita
M
Pérez Bárcena
Jon
J
Casares Vivas
Marcial
M
Homar Ramírez
Javier
J
Ibáñez Juvé
Jorge
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial / Q000379:methods*