Brain scans and echoencephalography in the diagnosis of chronic subdural hematoma.
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With the aid of a non-adapted equipment echoencephalotomogrammes were obtained that revealed fine details of intracranial structures in normals and in patients with space-occupying lesions, these tomogrammes being comparable to those obtained after anatomic sections of the skull in the same planes. This becomes possible thanks to the absence of the bone as a limiting factor. Interpreting the conducted examinations as a model of intraoperative scanning, and considering the results of experimental craniotomies, a conclusion is made as the importance of such investigations especially in cases of bilateral space-occupying lesions.
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A short survey is given of the use of ultrasound examinations in neurology. Special attention is paid to the original immersion technique of Dussik, the A-scan echoencephalographic technique and the non-directional and directional Doppler technique, which are described with particular reference to their applications in the field of neurological diagnosis.
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First results of neurological, electro-encephalographic and echo-encephalographic examinations obtained from three different groups consisting of former high-risk babies (about two thirds) and control children (about one third) are presented. As was to be expected, the control group showed remarkably fewer findings which differed from the physiological variation width. The comparatively high proportion of individual results without pathological findings obtained from high-risk children indicates that reliable diagnostic conclusions can be drawn only if the results of various examination techniques are summarized. The analysis of a neurological longitudinal study of former high-risk infants reveals a trend toward recession of the neurological peculiarities over the observation period which lasted until the sixth year of age. This particularly applies to light phenomena of a neurological character which do not have syndrome character and are pathologically irrelevant. As a result of different interpretations of what "high risks" are, considerable problems can arise when the results of examinations performed on groups of high-risk children by various workers are to be compared.
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