Imaging of spontaneous intracerebral hemorrhages by means of transcranial color-coded sonography

Abstract

Background: Transcranial color-coded sonography (TCCS) allows the visualization of cerebral structures and enables monitoring of circulatory disorders occurring within the circle of Willis. Objective: To verify whether TCCS is a reliable method in imaging intracerebral hemorrhages (ICHs) and to what degree its results are consistent with these by means of computed tomography (CT). Methods: This study included 39 patients with spontaneous ICHs of supratentorial and infratentorial locations. Initial TCCS was done not later than 12 h after initial CT. Clinical findings and the measurements of hemorrhagic foci and midline shift (MLS) were compared between these two methods. Results: TCCS revealed ICHs in 34 patients, including 29 and 5 with supra- and infratentorial localization, respectively. Moreover, it showed 12 cases (35.3%) of intraventricular hemorrhage (IVH) and 16 cases of a midline shift (MLS). No significant differences were found between the measurements of hemorrhagic foci or MLS obtained by TCCS and CT. There was a significant correlation between the volumes of hemorrhagic foci or MLS values measured by both methods analyzed (R = 0.99 or R = 0.98, respectively). Additionally, MLS was shown to increase significantly with the volume of hemorrhagic foci (R = 0.90). Conclusions: The high correlation between TCCS and CT in imaging spontaneous ICHs introduces the possibility of applying TCCS in everyday clinical practice. © 2011 Elsevier Ireland Ltd. All rights reserved.