Posttraumatic vasospasm and intracranial hypertension after wartime traumatic brain injury
Autor: | Robert D. Ecker, Scott A. Marshall, Meryl A. Severson, Rocco A. Armonda, Teodoro Tigno, Sven M. Hochheimer, Alexander Y. Razumovsky, Fred L. Stephens, Stephen M. Oppenheimer, Randy S. Bell, Alexander H. Vo |
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Rok vydání: | 2012 |
Předmět: |
Cerebral blood flow velocity
medicine.medical_specialty Intracranial pressure business.industry Traumatic brain injury medicine.medical_treatment Incidence (epidemiology) Vasospasm General Medicine medicine.disease Cranioplasty Combat associated wartime traumatic brain injury nervous system diseases Transcranial Doppler Surgery Wartime traumatic brain injury Cerebral vasospasm Anesthesia cardiovascular system medicine business Transcranial Doppler ultrasonography Cerebral arterial spasm |
Zdroj: | Perspectives in Medicine. 1(1-12):261-264 |
ISSN: | 2211-968X |
DOI: | 10.1016/j.permed.2012.02.043 |
Popis: | Summary Traumatic brain injury (TBI) is associated with the severest casualties from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). From October 1, 2008 the US Army Medical Department initiated a transcranial Doppler (TCD) ultrasound service for TBI patients; included patients were retrospectively evaluated for TCD-determined incidence of posttraumatic cerebral vasospasm and intracranial hypertension after wartime TBI. Ninety patients were investigated with daily TCD studies and comprehensive TCD protocol and published diagnostic criteria for vasospasm and raised intracranial pressure (ICP) were applied. TCD signs of mild, moderate and severe vasospasms were observed in 37%, 22% and 12% of patients, respectively. TCD signs of intracranial hypertension were recorded in 62.2%, five patients (4.5%) underwent transluminal angioplasty for post-traumatic clinical vasospasm treatment and 16 (14.4%) had cranioplasty. These findings demonstrate that cerebral arterial spasm and intracranial hypertension are frequent and significant complications of combat TBI, therefore daily TCD monitoring is recommended for their recognition and subsequent management. |
Databáze: | OpenAIRE |
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