Arteriovenous cerebral blood flow correlation in moderate-to-severe traumatic brain injury: CT perfusion study.

Autor: Trofimov AO; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia.; Lovelace Biomedical Research Institute, Albuquerque, NM, USA., Agarkova DI; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Trofimova KA; Department of Neurological Diseases, Privolzhsky Research Medical University, Nizhny Novgorod, Russia., Nemoto EM; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, USA., Bragina OA; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, USA., Bragin DE; Department of Neurology, University of New Mexico School of Medicine, Albuquerque, USA.; Lovelace Biomedical Research Institute, Albuquerque, NM, USA.
Jazyk: angličtina
Zdroj: Brain & spine [Brain Spine] 2023 Sep 21; Vol. 3, pp. 102675. Date of Electronic Publication: 2023 Sep 21 (Print Publication: 2023).
DOI: 10.1016/j.bas.2023.102675
Abstrakt: Introduction: The relationship between arterial and venous blood flow in moderate-to-severe traumatic brain injury (TBI) is poorly understood.
The Research Question: was to compare differences in perfusion computed tomography (PCT)-derived arterial and venous cerebral blood flow (CBF) in moderate-to-severe TBI as an indication of changes in cerebral venous outflow patterns referenced to arterial inflow.
Material and Methods: Moderate-to-severe TBI patients (women 53; men 74) underwent PCT and were stratified into 3 groups: I (moderate TBI), II (diffuse severe TBI without surgery), and III (severe TBI after the surgery). Arterial and venous CBF were measured by PCT in both the internal carotid arteries (CBFica) and the confluence of upper sagittal, transverse, and straight sinuses (CBFcs).
Results: In group I, CBFica on the left and right sides were significantly correlated with each other (p < 0.0001) and with CBFcs (p = 0.048). In group II, CBFica on the left and right sides were also correlated (P < 0.0000001) but not with CBFcs. Intracranial pressure reactivity (PRx) and CBFcs were correlated (p = 0.00014). In group III, CBFica on the side of the removed hematoma was not significantly different from the opposite CBFica (P = 0.680) and was not correlated with CBFcs.
Discussion and Conclusion: The increasing severity of TBI is accompanied by a rising uncoupling between the arterial and venous CBF in the supratentorial vessels suggesting a shifting of cerebral venous outflow.
Competing Interests: The authors declare that they have no conflict of interest.
(© 2023 The Authors.)
Databáze: MEDLINE