Midline shift is the shift of the brain past its diameter. These marks may be proven in neuroimaging such as CT scans. This sign is considered unpleasant because it is usually associated with brainstem distortion that can lead to serious dysfunction as evidenced by abnormal posture and narrow pupil failure in response to light. Centerline shifts are often associated with high intracranial pressure (ICP), which can be lethal. In fact, the midline shift is the size of ICP; The first presence is the last indication. The presence of midline shifts is an indication for neurosurgeon to take steps to monitor and control ICP. Immediate surgery may be indicated when there is a midline shift of more than 5 mm. Signs can be caused by conditions including traumatic brain injury, stroke, hematoma, or birth defects that lead to increased intracranial pressure.
Video Midline shift
Detection Method
Doctors detect midline shifts using various methods. The most prominent measurements were made with computed tomography (CT) scans and the CT Gold Standard was a standard operating procedure for detecting MLS. Because midline shifts are often readily apparent with CT scans, high precision Magnetic Resonance Imaging (MRI) is not required, but can be used with equally adequate results. More recent methods such as bedside sonography can be used with neurocritical patients who can not undergo multiple scans because of their dependence on ventilators or other treatment equipment. Sonography has been shown to be satisfactory in MLS measurements, but it is not expected to replace CT or MRI. The automatic measurement algorithm is used for precise recognition and precision in the measurement of early CT scans. The main benefits for using an automatic recognition tool include being able to measure even the most disabled brain because the method does not rely on normal brain symmetry. Additionally, it reduces the likelihood of human error by detecting MLS from the entire set of images compared to selecting one of the most important parts, allowing the computer to do the job ever done manually.
Maps Midline shift
Middle Line Structure
Three main structures are usually examined when measuring midline shifts. The most important is the pellucidum septum, which is a thin and linear layer of tissue located between the right and left ventricle. This is easy to find on a CT or MRI image because of its unique hypodensity. The other two important structures of the midline include the third ventricle and the pineal gland both located at the center and the tail to the pellucidum septum. Identifying the location of this structure in a damaged brain compared to an unaffected brain is another way of categorizing the severity of the midline shift. The terms mild, moderate, and severe are associated with an increased rate of damage.
Centerline Shift in Diagnosis
Middle line measurements and images have many applications. The severity of brain damage is determined by the magnitude of the symmetry change. Another use is secondary screening to determine irregularities in brain trauma at different times after traumatic injury as well as early shifts soon thereafter. The severity of the shift is directly proportional to the possibility of operations to be performed. MLS also has the ability to diagnose the pathology that causes it. MLS measurements can be used to successfully differentiate between various intracranial conditions including acute subdural hematoma, cerebral malignant cerebral infarction, epidural hematoma, subarachnoid hemorrhage, chronic subdural hematoma, infarct, intraventric bleeding, combination of these symptoms, or no associated damage at all.
See also
- Mass effect (drug)
References
Source of the article : Wikipedia
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