title: Cerebral Ventricular Dimensions After Decompressive Craniectomy: A Comparison Between Bedside Sonographic Duplex Technique and Cranial Computed Tomography.
abstract: BACKGROUND
  The objective of this study was to assess and compare ventricle diameters in patients after decompressive craniectomy by using cranial computed tomography (CCT) versus sonographic duplex technique (SDT).
  
  
  METHODS
  A total of 102 consecutive patients after decompressive craniectomy following brain infarct, bleeding and trauma were examined by CCT and SDT. SDT was performed within 24 h after repeated postinterventional control CCT and the correlation between both methods was assessed via measurement of dimensions of all four ventricles. In addition, midline shifts and overall cerebral anatomy was evaluated.
  
  
  RESULTS
  A high correlation was found between CCT and SDT in measuring the diameters of all four ventricles (right lateral r = 0.978, p < 0.001; left lateral r = 0.975, p < 0.001; third r = 0.987, p < 0.001 and fourth ventricle r = 0.954, p < 0.001). Deviations of midline structure was observed in SDT as well as in CCT (r = 0.992, p < 0.001).
  
  
  CONCLUSIONS
  SDT in patients after decompressive craniectomy may represent an additional bedside tool to assess the dimensions of the ventricular system, anatomical structures, e.g., subdural hygromas, hematomas, midline shifts, gyri and sulci. The measurement of the dimensions of all four ventricles by using SDT delivers accurate values and may be considered as an alternative to CCT or a trigger for CCT prior to further treatment.
authors.affiliation: Department of Neurosurgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109, Cologne, Germany. Habib@Bendella.de.
authors.forename: Habib
authors.initials: H
authors.lastname: Bendella
authors.affiliation: Department of Traumatology, Orthopedic Surgery and Sportsmedicine, Cologne-Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany.|Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne-Merheim, Cologne, Germany.
authors.forename: Marc
authors.initials: M
authors.lastname: Maegele
authors.affiliation: Department of Neurosurgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109, Cologne, Germany.|RehaNova Rehabilitation Hospital, Cologne-Merheim, Cologne, Germany.
authors.forename: Alexander
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Division of Neuroradiology, Department of Radiology, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Cologne, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Spreer
authors.affiliation: RehaNova Rehabilitation Hospital, Cologne-Merheim, Cologne, Germany.
authors.forename: Nadine
authors.initials: N
authors.lastname: Rommel
authors.affiliation: Institute for Research in Operative Medicine (IFOM), University of Witten/Herdecke, Cologne-Merheim, Cologne, Germany.
authors.forename: Rolf
authors.initials: R
authors.lastname: Lefering
authors.affiliation: Department of Neurosurgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109, Cologne, Germany.
authors.forename: Makoto
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Neurosurgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109, Cologne, Germany.
authors.forename: Alhadi
authors.initials: A
authors.lastname: Igressa
mesh_terms: D000328:Adult; D000368:Aged; D000070642:Brain Injuries, Traumatic / Q000601:surgery*; D002543:Cerebral Hemorrhage / Q000601:surgery*; D002544:Cerebral Infarction / Q000601:surgery*; D002552:Cerebral Ventricles / Q000000981:diagnostic imaging*; D056424:Decompressive Craniectomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods* / Q000592:standards; D019095:Point-of-Care Systems; D014057:Tomography, X-Ray Computed / Q000592:standards*; D018616:Ultrasonography, Doppler, Duplex / Q000592:standards*
keywords: Bedside examination; Brain trauma; Cranial computed tomography; Decompressive craniectomy; Sonographic duplex technique; Ventricle dimensions