Blood flow velocities in the basal cerebral vein after head trauma: a prospective study in 82 patients.
OBJECTIVE
The authors' aim was to evaluate the time course of the basal vein's (BVR) mean flow velocity (VBVR) in patients after traumatic brain injury and its relation to intracranial pressure (ICP), cerebral perfusion pressure (CPP), and the clinical outcome.


METHODS
In 82 head-injured patients (13 women and 69 men, median age = 31 years, Glasgow Coma Score = 15 to 3), daily measurement of the basal cerebral vein's and the middle cerebral artery's (MCA) flow velocities and pulsatilities was performed during each patient's entire stay in the intensive care unit. No angle correction was performed. A computerized sonography system (SD 800, Philips, Irvine, CA) with a 2.0-MHz to 2.5-MHz transducer was used for all measurements. The Glasgow Outcome Score (GOS) was evaluated after 6 months.


RESULTS
During the study period, VBVR values on the side of trauma were higher in the patients with favorable outcomes (GOS = 4 and 5) compared to patients with unfavorable outcomes (GOS = 2 and 3). This was statistically significant on days 4, 6, 7, and 11 and was not observed in the mean flow velocity of the MCA (VMCA). VBVR values among the good-outcome group tended to exceed the normal mean flow velocity (9.1 cm/s), whereas the unfavorable-outcome group was below this level. A correlation between venous flow velocity or pulsatility and ICP or CPP was not observed.


CONCLUSIONS
Repetitive Doppler examination of the basal cerebral veins may add new aspects to the monitoring of head-injured patients.
Mursch
Kay
K
Department of Neurosurgery, Georg-August-Universität Göttingen, Germany. kaymu@yahoo.de
Müller
Christian-Andreas
CA
Buhre
Wolfgang
W
Lang
Johannes K
JK
Vatter
Hartmut
H
Behnke-Mursch
Julianne
J
D000328:Adult; D000704:Analysis of Variance; D001783:Blood Flow Velocity; D002550:Cerebral Veins / Q000000981:diagnostic imaging*; D002560:Cerebrovascular Circulation; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging / Q000503:physiopathology*; D005260:Female; D015600:Glasgow Coma Scale; D006439:Hemodynamics; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D018709:Statistics, Nonparametric; D017585:Ultrasonography, Doppler, Transcranial