• Habib Bendella, Marc Maegele, Alexander Hartmann, Joachim Spreer, Nadine Rommel, Rolf Lefering, Makoto Nakamura, and Alhadi Igressa.
• Department of Neurosurgery, Cologne Merheim Medical Center (CMMC), University of Witten/Herdecke, Ostmerheimerstr. 200, 51109, Cologne, Germany. Habib@Bendella.de.
• Neurocrit Care. 2017 Jun 1; 26 (3): 321-329.

BackgroundThe objective of this study was to assess and compare ventricle diameters in patients after decompressive craniectomy by using cranial computed tomography (CCT) versus sonographic duplex technique (SDT).MethodsA total of 102 consecutive patients after decompressive craniectomy following brain infarct, bleeding and trauma were examined by CCT and SDT. SDT was performed within 24 h after repeated postinterventional control CCT and the correlation between both methods was assessed via measurement of dimensions of all four ventricles. In addition, midline shifts and overall cerebral anatomy was evaluated.ResultsA high correlation was found between CCT and SDT in measuring the diameters of all four ventricles (right lateral r = 0.978, p < 0.001; left lateral r = 0.975, p < 0.001; third r = 0.987, p < 0.001 and fourth ventricle r = 0.954, p < 0.001). Deviations of midline structure was observed in SDT as well as in CCT (r = 0.992, p < 0.001).ConclusionSDT in patients after decompressive craniectomy may represent an additional bedside tool to assess the dimensions of the ventricular system, anatomical structures, e.g., subdural hygromas, hematomas, midline shifts, gyri and sulci. The measurement of the dimensions of all four ventricles by using SDT delivers accurate values and may be considered as an alternative to CCT or a trigger for CCT prior to further treatment.

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