The use of ultrasonographic imaging of the intracranial contents through burr holes in infants with ventricular shunts.

To the Editor:-Slovis et al1 published a ·preliminary· report that described the use of ultrasonographic imaging of the intracranial contents through burr holes in infants with ventricular shunts. Although their paper is the first to describe this technique solely in infants, it is by no means the first report of such a technique. The first report of imaging through a postoperative defect was by Hoffman and Landau in 1975; later Gooding and colleagues published additional reports in 1981, and 1983. I and my colleagues at Thomas Jefferson University Hospital reported on sonographic imaging of 18 patients with a variety of intracranial pathologic conditions, 5 including hydrocephalus, through calvarial defects. Although the clinical utility of such techniques is limited, in certain selected cases sonography may be useful as an adjunct to CT or MRI. J.B. Rubenstein, MD Morristown Memorial Hospital Morristown, NJ