Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Case Reports
. 2021 Jun 18;2(3):e12419.
doi: 10.1002/emp2.12419. eCollection 2021 Jun.

Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound

Svetlana Zakharchenko  1 , Allyson Hansen  2 , Aminat Ibikunle  1 , Richard Devasagayaraj  1 , Patrick Charles  1
Affiliations
Case Reports

Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound

Svetlana Zakharchenko et al. J Am Coll Emerg Physicians Open. .

Abstract

A 60-year-old male presented to the emergency department with acute change in mental status while recovering from a recent hemicraniectomy. During evaluation by the emergency physician, a point-of-care ultrasound (POCUS) was performed using the patient's existing craniectomy site as a sonographic window. Multiple areas of intracranial hemorrhage were visualized on POCUS and head computed tomography scan ultimately requiring urgent neurosurgical intervention. Our case report demonstrates an innovative application of POCUS in the emergency department- setting that has potential to expedite diagnosis and management of life-threatening neurosurgical etiologies, such as hemorrhage and midline shift, in a unique patient population.

Keywords: POCUS; TCUS; brain; craniotomy; emergency; intracranial hemorrhage; neurosurgery; point of care ultasound; transcranial ultrasound; ultasound.

PubMed Disclaimer

Conflict of interest statement

Authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
POCUS demonstrating intracranial bleed through a craniotomy site with a curvilinear C5‐1s Transducer. Near field: a mixed‐echogenicity layer of postoperative edematous soft tissues, fluid, and clotted blood; Brain parenchyma: complex fluid with varying echogenicities suggesting different stages of hemorrhage; Far field: an anechoic layer concerning for acute hemorrhage
FIGURE 2
FIGURE 2
Critical non‐contrasted computed tomography image
See this image and copyright information in PMC

Similar articles

See all similar articles

References

    1. Robertson FC, Dasenbrock HH, Gormley WB. Decompressive hemicraniectomy for stroke in older adults: a review. J Neurol Neuromedicine. 2017;2(1):1‐7. - PMC - PubMed
    1. Nambiar M, MacIsaac C, Grabinski R, Liew D, Kavar B. Outcomes of decompressive craniectomy in patients after traumatic brain injury. Crit Care Resusc. 2015;17(2):67‐72. - PubMed
    1. Saqqur M, Zygun D, Demchuk A. Role of transcranial doppler in neurocritical care. Crit Care Med. 2007;35(5 Suppl):S216‐S223. - PubMed
    1. Caricato A, Mignani V, Sandroni C, Pietrini D. Bedside detection of acute epidural hematoma by transcranial sonography in a head‐injured patient. Intensive Care Med. 2010;36(6):1091‐1092. - PubMed
    1. Lacerda FH, Rahhal H, Soares LJ, Ureña FDRM, Park M. Intracranial epidural hematoma follow‐up using bidimensional ultrasound. Rev Bras Ter Inten‐siva. 2017;29(2):1‐2. - PMC - PubMed

Publication types