title: Detection and monitoring of cerebral hemodynamic disturbances with transcranial color-coded duplex sonography in patients after head injury.
abstract: Reduced cerebral blood flow after severe head injury results in an increased risk of ischemic brain damage. Blood flow should therefore be monitored with a simple, reliable method. Transcranial color-coded Doppler sonography (TCCS) is an accepted tool for the diagnosis of cerebral vasospasm; however, its usefulness in evaluating patients with head injury has not been proven. Cerebral blood-flow velocity in the middle, anterior, and posterior cerebral arteries was measured with a 2.5 MHz probe (Aplio SSA 770A, Toshiba, Japan) in 36 subjects with moderate or severe head injury. Serial measurements of resistance index (RI), peak-systolic, end-diastolic, and mean velocity in the middle cerebral arteries were performed 2-24 h after head trauma and in the subsequent days during hospitalization. Immediately after head trauma, increased RI values, and unusually decreased blood-flow velocity (mainly in MCA) were observed. Microcirculation disturbances were suspected because the end-diastolic velocity had substantially diminished. Changes in blood-flow parameters correlated with the clinical state, and in most cases, a poor prognosis. In some patients, blood-flow velocity increased above the normal reference limit and this implied poor prognosis. Transcranial color-coded Doppler sonography is a reliable, repeatable, and accessible tool that provides information about cerebral blood-flow disturbances and may hold diagnostic and prognostic importance.
authors.affiliation: Department of Neurosurgery, Medical University of Bialystok, Kilinskiego 1, Bialystok, 15089, Poland.
authors.forename: J
authors.initials: J
authors.lastname: Kochanowicz
authors.forename: J
authors.initials: J
authors.lastname: Krejza
authors.forename: Z
authors.initials: Z
authors.lastname: Mariak
authors.forename: M
authors.initials: M
authors.lastname: Bilello
authors.forename: T
authors.initials: T
authors.lastname: Lyson
authors.forename: J
authors.initials: J
authors.lastname: Lewko
mesh_terms: D001783:Blood Flow Velocity; D002536:Cerebral Arteries / Q000000981:diagnostic imaging* / Q000293:injuries*; D006259:Craniocerebral Trauma / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D016018:Least-Squares Analysis; D008297:Male; D011379:Prognosis; D018615:Ultrasonography, Doppler, Color; D017585:Ultrasonography, Doppler, Transcranial