Use of Transcranial Sonography for Assessment of Brain Midline Shift In Neurocritical Patients: A Systematic Review

Abstract

Brain midline shift (MLS) in neurocritical patients is a life-threatening condition that requires urgent diagnosis and treatment. The early detection of MLS in neurocritical patient is thus very important because it allows starting an appropriate treatment plan to improve morbidity and mortality. Head CT is considered to be the gold standard tool to diagnose MLS. Transcranial sonography (TCS) is a bedside neuroimaging technique which is safe, painless and accurate. The aim of this study is comparing the accuracy of TCS in measuring brain MLS in neurocritical patient to Head CT. In this systematic review we selected 10 studies were published in the last 20 years that compared TCS to head CT as a tool in measuring MLS in neurocritical patients and we found that TCS can detect and monitor MLS with only a small difference in comparison to head CT. So, it provides a cheap, accurate and non-invasive bedside tool for diagnosis and monitoring of brain MLS