Transcranial ultrasound diagnosis of intracranial lesions in children with headaches

Wang, Huei-Shyong; Kuo, Meng-Fai; Huang, Song-Chei; Chou, Ming-Liang; Hung, Po-Chen; Lin, Kuang-Lin

« Previous Next »Pediatric Neurology
Volume 26, Issue 1 , Pages 43-46, January 2002

Transcranial ultrasound diagnosis of intracranial lesions in children with headaches

Huei-Shyong Wang, MD
- Communications should be addressed to: Dr. Wang, Division of Pediatric Neurology, Chang Gung Children’s Hospital, 199, Tung-Hwa North Road, Taipei, 10591 Taiwan
- Division of (Pediatric) Neurology, Chang Gung Children’s Hospital, Medical College of Chang Gung University; Taipei, 10591 Taiwan
Meng-Fai Kuo, MD, PhD
- Division of (Pediatric) Neurosurgey, Department of Surgery, National Taiwan University Hospital, Taipei, Taiwan
Song-Chei Huang, MD
- Division of (Pediatric) Neurology, Chang Gung Children’s Hospital, Medical College of Chang Gung University; Taipei, 10591 Taiwan
Ming-Liang Chou, MD
- Division of (Pediatric) Neurology, Chang Gung Children’s Hospital, Medical College of Chang Gung University; Taipei, 10591 Taiwan
Po-Chen Hung, MD
- Division of (Pediatric) Neurology, Chang Gung Children’s Hospital, Medical College of Chang Gung University; Taipei, 10591 Taiwan
Kuang-Lin Lin, MD
- Division of (Pediatric) Neurology, Chang Gung Children’s Hospital, Medical College of Chang Gung University; Taipei, 10591 Taiwan

Received 29 May 2001; accepted 10 August 2001.

Abstract

The diagnostic value of transcranial ultrasound for intracranial lesions in children with headaches was evaluated. From January 1995 to December 1998, 444 children with headaches for more than 2 weeks visited our Pediatric Neurologic and Neurosurgical Outpatient Clinics. A 2-MHz-sector sonographic transducer was used to perform transcranial ultrasound. Nineteen patients were lost to follow-up. Two patients, both 15 years of age, failed to have a successful examination. Thirteen of the enrolled 423 patients presented with headaches and other symptoms and positive neurologic signs and had positive magnetic resonance imaging findings of intracranial lesions correlating with their transcranial ultrasound findings. Twelve of the remaining 410 children complaining of isolated headache had abnormal transcranial ultrasound findings. Nine of the 12 patients were confirmed to have intracranial lesions by magnetic resonance imaging studies. Among the nine patients, five had brain tumors, two patients had hydrocephalus, one patient had intracerebral hematoma, and one patient had temporal arachnoid cyst. The other three patients were misinterpreted to have a suprasellar lesion by transcranial ultrasound. These three patients and the remaining 398 children were regularly followed for at least 12 months. All revealed no evidence of an intracranial lesion. The sensitivity and specificity of transcranial ultrasound to detect intracranial lesions for children with isolated headaches were 75% and 99.7%, respectively. The average saving from utilizing this technique was $222 U.S. dollars per person. We suggest that transcranial ultrasound study is a reliable, convenient, time-saving, and economic diagnostic tool in detecting intracranial lesions in children with headaches.