Síndrome de Lemierre en paciente adulto con circulación de Fontan / Lemierre Syndrome in an adult patient with Fontan circulation

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Monitoring midline shift by transcranial color-coded sonography in traumatic brain injury. A comparison with cranial computerized tomography.

OBJECTIVE: Transcranial color-coded duplex sonography (TCCDS) is a non invasive bedside technique that allows the determination of midline shift (MLS). The purpose of our study was to compare MLS measurements using TCCDS with those obtained with cranial computerized tomography (CT) in patients with traumatic brain injury (TBI). DESIGN: Prospective study. SETTINGS: Intensive care unit in a university hospital. PATIENTS: Forty-one traumatic brain-injured patients (35 men and 6 women). INTERVENTIONS: A total of 60 studies were conducted with a time interval between the cranial CT and the TCCDS studies of 322+/-216 min. RESULTS: The coefficient of correlation between MLS measured by CT and TCCDS was 0.88, the bias was 0.12 mm, the precision was 1.08 mm and the limits of agreement were +2.33 to -2.07 mm. There were no statistically significant differences in MLS measured by the two techniques in terms of: sex, age or type of lesion according to the Traumatic Coma Data Bank classification. CONCLUSION: The TCCDS is a non-invasive bedside technique that is valid for determining MLS in patients with traumatic brain injury. Due to the risks involved in the transportation of traumatic brain-injured patients to the radiology department, this bedside technique is specially interesting in these patients.