CRANIAL ULTRASOUND THROUGH A BONE-WINDOW: BEDSIDE EVALUATION OF POST-TRAUMATIC HYDROCEPHALUS AND MIDLINE SHIFT.

382 patients with serious (Glasgow Coma Score, GSC, of 7 or less) close head injury (CHI) were treated in a surgical intensive care unit. Intra-cranial pressure monitors were surgically placed in 81% of these patients. During the same surgical procedure. 25 of these patients also underwent removal of 3 cms multiplied by 2 cms of the parietal bone immediately anterior to the burr-hole for the ICP monitor ('bone-window'). This was performed for the bedside ultrasound evaluation of the ventricular size, shift of the mid-line structures and intraparenchymal hemorrhages. This technique offers advantage over computed tomography (CT) because the examination can be safely performed in the intensive care unit without moving the critically sick CHI patients.