The use of echoencephalography to differentiate intracerebral hemorrhage and brain softening.

Abstract

U 'LTRASOUND wave was first used in the diagnosis of intracranial disease by Dussik 2 in 1942 when he applied an ultrasonic transmission method. In recent years a reflection method has been used with excellent results. Ultrasonic diagnosis of intracranial disease is based on the observation of the shift of the midline echo, which corresponds with the reflected echo of the midline structure, as well as on the observation of the reflected echo derived from the intracranial lesion itself. We have found in our surgical treatment of hypertensive intracerebral hemorrhage that it has often been difficult to differentiate intracerebral hemorrhage from cerebral softening. In intracerebral hemorrhage the echogram shows a midline echo shift whereas in cerebral softening there is none. We have found, however, that when the hematoma is small enough not to produce a midline echo shift, the hematoma echo with its multiple spike-like pattern derived from hematoma itself is a better diagnostic guide. 6-8 We are now reporting our experiences with echoencephalography in the differential diagnosis of intracerebral hemorrhage, cerebral softening, and subarachnoid hemorrhage.