[[Computerized tomography]] (CT) remains the initial [[neuroimaging]] tool of choice for acute [[Intracranial Hemorrhage]] [[Diagnosis]]
((Heit JJ, Iv M, Wintermark M. Imaging of [[Intracranial Hemorrhage]]. J Stroke. 2017 Jan;19(1):11-27. doi: 10.5853/jos.2016.00563. Epub 2016 Dec 12. PMID: 28030895; PMCID: PMC5307932.)).
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A 60-year-old male presented to the [[emergency department]] with acute change in mental status while recovering from a recent [[hemicraniectomy]]. During evaluation by the emergency physician, a point-of-care [[ultrasound]] ([[POCUS]]) was performed using the patient's existing craniectomy site as a sonographic window. Multiple areas of [[intracranial hemorrhage]] were visualized on POCUS and head computed tomography scan ultimately requiring urgent neurosurgical intervention. This case report demonstrates an innovative application of POCUS in the [[emergency department]]- setting that has potential to expedite diagnosis and management of life-threatening neurosurgical etiologies, such as hemorrhage and midline shift, in a unique patient population
((Zakharchenko S, Hansen A, Ibikunle A, Devasagayaraj R, Charles P. Intracranial hemorrhage detected through a craniotomy site with point of care ultrasound. J Am Coll Emerg Physicians Open. 2021 Jun 18;2(3):e12419. doi: 10.1002/emp2.12419. PMID: 34179872; PMCID: PMC8212560.)).