Transcranial Sonography vs. CT scans: A Prospective Study on Brain Midline Shift Assessment in Traumatic Brain Injury Cases
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Keywords
brain midline shift, computed tomography, transcranial sonography
Abstract
Brain midline shift (MLS) is a crucial marker of intracranial issues requiring prompt diagnosis and intervention. While computed tomography (CT) scans are the gold standard, their repeated use in neurosurgical ICUs carries risks. Transcranial sonography (TCS) offers a noninvasive MLS assessment alternative.
Methods: A prospective cohort study involving 50 traumatic brain injury (TBI) patients was conducted to compare TCS MLS measurements with CT MLS measurements. Various clinical parameters, including Glasgow Coma Scale (GCS), ICU days, and ventilation days, were assessed alongside MLS sizes.
Results: TCS MLS exhibited a weak significant correlation with CT MLS (r = 0.0483, p = 0.001), while CT MLS demonstrated a moderate and highly significant correlation with TCS MLS (r = 0.635, p < 0.001). TCS MLS accurately detected MLS sizes, with mean measurements of 4.33 ± 2.11, whereas CT MLS had a mean of 5.43 ± 2.66.
Conclusion: This investigation underscores the potential of TCS as a valuable method for diagnosing MLS in TBI patients when compared to CT scans. Despite weak correlations, TCS provides a bedside, noninvasive option for early MLS detection, contributing to timely interventions. The study's findings suggest that TCS could reduce radiation exposure, enhance MLS assessment, and improve patient care in neurocritical settings.
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