A-scan echoencephalography in measurement of the cerebral ventricles.
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In cases of hydrocephalus, echoes from the region of the cerebral median segittal plane may show a fluttering variation both in amplitude and range. Evidence is presented that, in the case studied, these movements arose from the falx cerebri and that they were caused by ballistocardiac forces presumably setting the CSF in the enlarged lateral ventricles into resonance within the enlarged cranium. Similar movements would be expected in the lateral ventricular walls as well as the septum pellucidum when the latter is imperforate. It is suggested that the lowering of the resonant frequency of the ventricular CSF in cases of hydrocephalus with both large ventricles and large heads allows ballistic and acceleratory forces applied to the hydrocephalic head to cause large pressure changes between the two lateral ventricles with consequent lateral movement of the midline structures separating them and possible rupture of the septum pellucidum, as is commonly found in hydrocephalus.
A new form of ultrasound diagnostic possibility is presented (the electroscan). The basic principles of this two dimensional method are described. Special attention is given to the probe consisting of an array of 21 elements of piezo-electric material. The results of this method in four patients are discussed (meningioma, arteriovenous aneurysm, subdural haematoma, and a baby with hydrocephalus). The baby with hydrocephalus showed diagnostic problems which could be understood from the pneumoencephalographic findings. The electroscan method seems to offer good possibilities for the diagnosis of brain lesions, if these have a consistency different from that of normal brain tissue.
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