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Monitoring midline shift by transcranial color-coded sonography in traumatic brain injury
Authors:Juan?Antonio?Llompart Pou  author-information"  >  author-information__contact u-icon-before"  >  mailto:ja_llompart@hotmail.com"   title="  ja_llompart@hotmail.com"   itemprop="  email"   data-track="  click"   data-track-action="  Email author"   data-track-label="  "  >Email author,Josep?María?Abadal Centellas,Margarita?Palmer Sans,Jon?Pérez Bárcena,Marcial?Casares Vivas,Javier?Homar Ramírez,Jorge?Ibá?ez Juvé
Affiliation:(1) Servicio de Medicina Intensiva y Unidad Coronaria, Hospital Universitario Son Dureta, Palma de Mallorca, Baleares, Spain;(2) Servicio de Radiodiagnóstico, Hospital Universitario Son Dureta, Palma de Mallorca, Baleares, Spain
Abstract: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).Design Prospective study.Settings Intensive care unit in a university hospital.Patients Forty-one traumatic brain-injured patients (35 men and 6 women).Interventions 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.Conclusion 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.Electronic Supplementary Material Supplementary material is available in the online version of this article at
Keywords:Traumatic brain injury  Transcranial color-coded sonography  Midline shift
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