Application of ultrasound in assessing intracranial conditions in patients with severe traumatic brain injury

WANG Yan-gang; ZHENG Xian-zhao; LÜ Zhen-pu; QIN Zheng; LI Jian-xin; GE Ran; ZHAO Fei-fei

doi:10.13798/j.issn.1009-153X.2025.02.002

Abstract：Objective To explore the value of ultrasound in the assessment of intracranial conditions in patients with severe traumatic brain injury.Methods The clinical data of 31 patients with severe traumatic brain injury who underwent craniotomy between January 1,2022,and June 30,2023,were retrospectively analyzed.Intraoperative ultrasound exploration or ultrasound-guided placement of intracranial pressure monitoring probes was performed based on clinical needs.Postoperative ultrasound via the bone window was used to monitor the progression of hydrocephalus,cerebral edema,or to guide puncture of intracerebral hematomas.Results All 31 patients underwent emergency craniotomy for hematoma evacuation,including 10 who underwent unilateral decompressive craniectomy.Intraoperative ultrasound was used in all cases:4 cases revealed cerebral bulging,3 cases showed new contralateral hematomas,1 case exhibited increased hematoma volume,and 7 cases involved ultrasound-assisted probe placement;no abnormalities were detected in the remaining 20 cases.Postoperative ultrasound in the 10 decompressive craniectomy cases identified hydrocephalus in 3 cases and guided hematoma puncture in 1 case,while the other 6 cases showed no significant progression of hydrocephalus or hemorrhage.One patient was lost to follow-up.The remaining 30 patients were followed up for 6 months,with 22 showing good prognosis and 8 having poor prognosis(including 2 deaths).Conclusion Ultrasound provides clear visualization of brain tissue and intracranial lesions,characterized by rapidity,accuracy,radiation-free operation,and repeatability.It holds significant value for intraoperative and postoperative monitoring in patients with severe traumatic brain injury,particularly after decompressive craniectomy.