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Abstract
Introduction Postoperative rebleeding is a common complication of minimally invasive surgical evacuation for intracerebral hemorrhage (ICH). While computed tomography (CT) is the standard of care for postoperative hematoma cavity monitoring, it entails significant logistical and financial burdens. This study aims to evaluate the feasibility of transcranial ultrasound with sonolucent cranioplasty in postoperative ICH patients.
Materials and Methods Consecutive patients who underwent minimally invasive ICH evacuation and subsequent cranioplasty with 2 cm clear polymethyl methacrylate implant were enrolled. Postoperative sonography was performed. Patient demographics including age, gender, preoperative hematoma volume, postoperative hematoma volume, infection rate, and revision rates were analyzed.
Results Sixteen consecutive patients (50% male, median age 67 years [IQR 59-75], median preoperative volume 61 mL [IQR 25-86], median postoperative volume 10.1 mL [IQR 3-15], median evacuation percentage 84.2% [IQR 61-92]) underwent cranioplasty after minimally invasive ICH evacuation. External ventricular drains were placed postoperatively in 43.8% (7/16). Image quality varied by operator, ultrasound system, and postoperative changes. There were no incision infections, ventriculostomy infections, or cranioplasty revisions.
Conclusion Transcranial ultrasound through sonolucent cranioplasty is safe and feasible in postoperative intracerebral hemorrhage patients. There were no infections or revisions. This imaging technique may alleviate the cost, transport, and radiation burden of CT in select ICH patients.
Disclosures C. Rossitto: None. H. Tabani: None. A. Reynolds: None. C. Kellner: 1; C; CPK receives research funding from Longeviti Neuro Solutions, Penumbra, Integra, Viz.AI, Minnetronix, Siemens, and Cerebrotech.