Use of Transcranial Doppler in Patients with Severe Traumatic Brain Injuries
| Autor: | Raj Gandhi, Mark Tellez, Daniel Ziegler, Gerard Poche, George F. Cravens |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Adult
Male Adolescent Ultrasonography Doppler Transcranial 030204 cardiovascular system & hematology Severity of Illness Index 03 medical and health sciences Young Adult 0302 clinical medicine medicine.artery Severity of illness Brain Injuries Traumatic medicine Humans Vasospasm Intracranial Glasgow Coma Scale Young adult Aged Aged 80 and over business.industry Vasospasm Middle Aged medicine.disease Transcranial Doppler Hospitalization Cerebral blood flow Anesthesia Cerebrovascular Circulation Middle cerebral artery cardiovascular system Female Neurology (clinical) business Perfusion 030217 neurology & neurosurgery Follow-Up Studies |
| Zdroj: | Journal of neurotrauma. 34(1) |
| ISSN: | 1557-9042 |
| Popis: | Severe traumatic brain injuries (TBI) are associated with a high rate of mortality and disability. Transcranial Doppler (TCD) sonography permits a noninvasive measurement of cerebral blood flow. The purpose of this study is to determine the usefulness of TCD in patients with severe TBI. TCD was performed, from April 2008 to April 2013, on 255 patients with severe TBI, defined as a Glasgow Coma Scale score of ≤8 on admission. TCD was performed on hospital days 1, 2, 3, and 7. Hypoperfusion was defined by having two out of three of the following: 1) mean velocity (Vm) of the middle cerebral artery35 cm/sec, 2) diastolic velocity (Vd) of the middle cerebral artery20 cm/sec, or 3) pulsatility index (PI) of1.4. Vasospasm was defined by the following: Vm of the middle cerebral artery120 cm/sec and/or a Lindegaard index (LI)3. One hundred fourteen (45%) had normal measurements. Of these, 92 (80.7%) had a good outcome, 6 (5.3%) had moderate disability, and 16 (14%) died, 4 from brain death. Seventy-two patients (28%) had hypoperfusion and 71 (98.6%) died, 65 from brain death, and 1 patient survived with moderate disability. Sixty-nine patients (27%) had vasospasm, 31 (44.9%) had a good outcome, 16 (23.2%) had severe disability, and 22 (31.9%) died, 13 from brain death. The vasospasm was detected on hospital day 1 in 8 patients, on day 2 in 23 patients, on day 3 in 22 patients, and on day 7 in 16 patients. Patients with normal measurements can be expected to survive. Patients with hypoperfusion have a poor prognosis. Patients with vasospasm have a high incidence of mortality and severe disability. TCD is useful in determining early prognosis. |
| Databáze: | OpenAIRE |
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