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[2-dimensional echoencephalography or cranial CT in premature or newborn infants with suspected intracranial hemorrhages].

65 newborns or low-birthweight infants with suspicion of intracranial hemorrhage were examined with B-mode small part scanners. In 12 cases the diagnosis made by ultrasound could be compared with CT. There was a similar accuracy of both methods in case of intraventricular (IVH) and subependymal (SEH) hemorrhage. SEH seems to be easier detected by US. On the other hand there are problems in diagnosing subdural (SDH) and intracerebral (IHC) hemorrhages by US. These problems are caused by the adjacent skull, but does not exist for CT. B-mode-Echoencephalography is the method of choice for examination of high risk infants and for the follow up, because US is a cribside method and of high diagnostic accuracy. CT-studies should be done in case of hemorrhage adjacent to the skull and if the US-diagnosis seems not to be reliable.

Cerebral Hemorrhage↗

[Diagnosis of internal hydrocephalus using echoencephalography and computerized tomography of the brain].

Using computer tomography and echoencephalography 20 subjects with normal pattern of the lateral ventricles and 20 patients with dilatation of these ventricles were studied. The patients were hospitalized in the Neurology Department of the Vienna University. On CT scans the distance between the anterior horns and heads of the caudate nuclei, and cranial width were measured and appropriate indices were calculated. In Echo-EG the position of the temporal horn was established and the cerebral pallium index was calculated. It was found that different indices in CT examination differ in subjects with normal lateral ventricles and in patients with internal hydrocephalus. In cases of hydrocephalus the index of the caudate nucleus was greater and the index of the anterior horns was smaller. The per cent indices in these cases were higher than in subjects with normal ventricles. In the patients with hydrocephalus the index of cerebral pallium calculated from Echo-EG was greater than in subjects with normal ventricles. Both diagnostic methods are regarded as useful for evaluating internal hydrocephalus, especially since they are non-invasive.

Adolescent↗

[Value of echoencephalography through the fontanelle in neonates and infants (author's transl)].

Echoencephalography through the fontanelle provides a complete scan of the head allowing the study of the ventricular system and cerebral parenchyma. The closure of the anterior fontanelle is the only limiting factor for this remarkably innocuous technique which is easy to perform (even in neonates under artificial ventilation in incubators), easy to repeat and relatively cheap. The authors report the results of 700 ultrasonic examinations carried out in 467 children. The echostructure of the brain, is studied in detail in 70 normal subjects (30 prematures, 31 at term neonates and infants under 1 year of age). In a population of 397 sick children the abnormal pictures were analysed according to clinical circumstances: perinatal distress (n = 107), prematurity (n = 81), hydrocephalus (n = 31), malformations (n = 9)... Our results confirm the usefulness of this technique for the early anatomic evaluation of any high-risk brain and for the follow-up of the lesions. The respective values of echography through the fontanelle, transcranial echography and computed tomography are discussed.

Brain↗

Application of one-dimensional echoencephalography to diagnosis of brain death.

Three groups of patients were studied by echoencephalography using a one-dimensional encephalograph Eho 12. The first group consisted of 100 patients with a mild craniocerebral traumas. Good pulsations of the elements of the echoencephalogram were found during the study. The second group involved 14 people who had died as a result of craniocerebral trauma. The investigation performed postmortem revealed fixed echoencephalogram without any pulsations of its elements. The third group included 11 patients with severe craniocerebral trauma in a state of deep coma. These patients were on mechanical ventilation, their brainstem reflexes were absent, but the cardiac activity remained preserved. The echoencephalographic study in these patients showed a fixed screen curve, without pulsations of its elements. We conclude that absence of pulsations of the elements of echoencephalogram produced by one-dimensional echoencephalograph indicates brain death of the investigated patients. This investigation should be included as a component of the established diagnostic tests.

Brain Death↗