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[Ultrasonic studies of craniocerebral injuries in infants]
1Kinderchirurgische Abteilung des St. Barbara-Krankenhauses, Halle/S.
Insights
Cranial ultrasound effectively diagnoses head injuries in infants, identifying edema, hematomas, and ventricular changes. This imaging aids in timely surgical decisions for better outcomes.
Area of Science:
- Pediatric Neurology
- Diagnostic Imaging
- Neurotrauma
Background:
- Closed-head injuries in infants pose diagnostic challenges.
- Early detection of intracranial abnormalities is crucial for management.
Purpose of the Study:
- To evaluate the diagnostic capabilities of sonography in infants with closed-head injuries.
- To describe sonographic findings associated with traumatic brain injury in this population.
Main Methods:
- Cranial sonography performed via the anterior fontanelle in 46 infants with head injuries.
- Real-time scanning to assess cerebral edema, arterial pulsations, and hematomas.
- Sonographic follow-up of extradural and subdural hematomas and effusions.
Main Results:
- Sonography identified traumatic edema with increased echogenicity and arterial pulsations.
- Distinct sonographic signs for epidural and subdural hematomas were described.
- Intracerebral hemorrhages and edema caused ventricular system alterations.
- Three cases of subdural hematoma required surgical intervention due to increased intracranial pressure (ICP).
Conclusions:
- Cranial sonography is a valuable, non-invasive tool for diagnosing and monitoring head-injured infants.
- Sonographic findings, combined with clinical assessment and ICP monitoring, guide decisions on surgical intervention, such as trepanation.
Abstract:
This is a report on the sonographic diagnostic possibilities in 46 closed-head injured infants. Cerebral examination via the anterior fontanelle is completed by additional sections of the surface of the brain. The traumatic oedema is limited in most cases and - besides the increase in echogenicity - an increase of the arterial pulsation at the border of the oedema is seen in real-time scanning. The sonographic signs of the epidural and subdural haematomas are described and also the differentiation between both. Surgical treatment was necessary in three cases of subdural haematoma because of increasing ICP. Treatment of extradural and chronical subdural haematomas or effusions is discussed in connection with the sonographic follow-up. Alterations in symmetry and compression of the ventricular system is often caused by intracerebral haemorrhages and-or traumatic local oedema. Parenchymal cysts may occur after liquefaction of cerebral necrosis or clots. The advantage of the cerebral sonographic examination is the uncomplicated follow-up. In connection with the clinical state and with continuous registration of ICP, sonographic findings facilitate the decision if, where and when trepanation must be performed.