- Usefulness of intraoperative transcranial sonography in patients with traumatic brain injuries: a comparison with postoperative computed tomography
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Mahn Jeong Ha, Seung Han Yu, Jung Hwan Lee, Hyuk Jin Choi, Byung Chul Kim
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J Trauma Inj. 2023;36(1):8-14. Published online June 20, 2022
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DOI: https://doi.org/10.20408/jti.2021.0093
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 Abstract
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- Purpose
The aim of this study was to assess the agreement between intraoperative transcranial sonography (TCS) and postoperative computed tomog¬raphy (CT) in patients with traumatic brain injuries.
Methods
We performed a retrospective cross-sectional study of 35 patients who underwent TCS during surgery, among those who presented to a regional trauma center and underwent decompressive craniectomy between January 1, 2017 and April 30, 2020.
Results
The mean difference between TCS and CT in measuring the midline shift was –1.33 mm (95% confidence inter¬val, –2.00 to –0.65; intraclass correlation coefficient [ICC], 0.96; P<0.001). An excellent correlation was found between TCS and CT in assessing contralateral subdural hematomas (ICC, 0.96; P<0.001) and focal hematoma lesions (ICC, 0.99; P<0.001). A very good correlation between TCS and CT was found for measurements of ventricle width (ICC, 0.92; P<0.001).
Conclusions
TCS during surgery is considered an effective diagnostic tool for the detection of intraoperative parenchymal changes in patients with traumatic brain injuries.
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Summary
- Successful minimally invasive reduction surgery with a micro burr hole in a pediatric patient with depressed skull fracture: a case report
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Seung Han Yu, Hyuk Jin Choi, Byung Chul Kim, Mahn Jeong Ha
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Received January 21, 2025 Accepted April 14, 2025 Published online June 25, 2025
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DOI: https://doi.org/10.20408/jti.2025.0015
[Epub ahead of print]
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Abstract
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- A 5-year-old female pediatric patient with head trauma was transferred to our regional trauma center. A depressed skull fracture measuring 45 mm in diameter and 6 mm in depth was diagnosed using a 3-dimensional (3D) computed tomography (CT) scan. Despite the absence of significant neurological symptoms, the extent of the depression necessitated surgical intervention on the third day of hospitalization. Using a 2 mm micro burr, two holes were drilled at strategically selected points of the fracture identified by 3D CT. Adson blunt dissecting hooks were inserted through the burr holes to elevate and reduce the fracture. Postoperative CT scans, including a follow-up scan on the 36th day, demonstrated stable reduction. The minimally invasive technique applied for pediatric depressed skull fracture reduction may significantly reduce pain, shorten recovery time, and decrease hospitalization duration, yielding favorable outcomes.
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