Comparative Study between Computed Tomography of Brain and Trans-Cranial Ultrasonography in Detecting Midline Shift in Severe Traumatic Brain Injury

Abstract

Abstract Background Traumatic brain injury (TBI) is the leading cause of mortality and morbidity in patients in the age group of 18–45 years. Most of the victims survive with significant disabilities, culminating in a major socioeconomic burden for both patients and their families. Objective To study the ability of trans-cranial ultrasonography in detecting and measuring midlineshift in comparison to computed tomography of brain in severe traumatic brain injury. Patients and Methods This was a cross-sectional comparative study that was conducted at Ain Shams university hospital’s intensive care units. The study was carried out on 40 adult critically ill patients of both sexes with severe traumatic brain injury underwent conservative treatment for 48 hours. Patients were randomly enrolled in 6 months. Results There was a high statistical significance correlation between measurements of midline shift by ultrasound (U/S) with the two methods of measurement by computed tomography (CT) “CT 1 and CT 2” on admission and also after 48 hours from admission. In this study, measurements of midline shift (MLS) in less than 8 mm is more accurate and the more increase in MLS may increase the difference between U/S and CT measurements of MLS. Conclusion This study suggests that transcranial sonography “TCS” could detect and measure MLS with reasonable accuracy as compared with the gold standard method computed tomography “CT” in severe traumatic brain injury patients on conservative treatment that it could serve as a bedside tool to facilitate early diagnosis and follow up treatment of midline shift specially in patients with MLS less than 8 mm however patients with MLS 8 mm or more need to be furtherly assessed.