Echoencephalography: An Aid in the Diagnosis of Intracranial Lesions

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ECHOENCEPHALOGRAPHY is a diagnostic procedure in which minute and harmless quantities of pulsed ultrasound are used to measure physical characteristics of the intracranial contents. It can detect slight changes in tissue density and elasticity such as those between white and gray matter, or those of interfaces between the ventricular wall and the ventricular fluid. However, its strongest and most easily recognized wave forms (echoes) come from midline brain structures, particularly the pineal body because of its calcium content.1

While in Sheffield, England, in June of 1962, one of us (T.M.T.) visiting with Mr. Anthony Jefferson, F.R.C.S., was introduced to echoencephalography and echoencephalographic technic. The intriguingly simple and harmless test could be done rapidly and repeatedly. Mr. Jefferson’s machine was a converted industrial model. Since then, a highly versatile and specialized electronic ultrasound machine (Fig. 1) has been designed which can measure with extreme accuracy the position of the pineal body with respect to the lateral walls of the skull. A 2.0 mm.- lateral dislocation of the pineal echo definitely indicates that a pathologic condition is causing the displacement.1 An expanding supratentorial lesion shifts the pineal structure away from the midline so that the lesion is lateralized by the direction of the shift (Fig. 2). A double-exposed Polaroid photograph is taken of the oscilloscopic tracing to make a permanent record of readings from the right and then from the left side of the skull. The test is easily performed and the results are immediately available for interpretation.

The usefulness of this. . .



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