The use of echoencephalography to differentiate intracerebral hemorrhage and brain softening

Experimental study of high-resolution ultrasound imaging of hemorrhage, bone fragments, and foreign bodies in head trauma

The accuracy of high-resolution ultrasound scans in detecting foreign bodies and hemorrhage within the brain was evaluated by comparison with computerized tomography (CT) scans and gross pathology. The test lesions were blood and foreign bodies consisting of bone, wood, and metal placed in the brain of an experimental animal. High-resolution ultrasound scans (10 MHz) performed in coronal and sagittal planes accurately delineated the position and spatial orientation of these foreign bodies and hemorrhage. Both hemorrhage and foreign bodies were echogenic compared to normal, hypoechoic brain parenchyma. Metal fragments had a highly characteristic echo pattern caused by sound reverberation within the object. Acute intracerebral hemorrhage produced an ultrasound image consisting of sharply circumscribed homogeneous echoes. The sonographic shape of intracerebral hemorrhage correlated closely with the area of increased density seen on the CT scan. High-resolution ultrasonography accurately delineated experimentally produced components of head trauma and may prove useful as an intraoperative imaging technique to facilitate surgery in head-injured patients.

Echoencephalography--an evaluation in general medical wards

Echoencephalography was performed on 80 patients with suspected intracranial pathology admitted to the medical unit of a general hospital. The accuracy of the technique in detecting the position of the midline structures, was found to be 91 per cent as confirmed in 32 patients by cerebral angiography, position of a calcified pineal body or by autopsy. The value of echoencephalography in the diagnosis of cerebro-vascular accidents and in the recognition of space occupying lesions is assessed. It is suggested that cerebro-vascular accident cases showing midline shift, should have further neurological investigation with a view to possible haematoma drainage. The presence of shift in patients with gradual onset of neurological signs and symptoms is considered strong evidence of a space occupying lesion.