title: Changes in cerebral blood flow from the acute to the chronic phase of severe head injury.
abstract: We studied cerebral blood flow (CBF) in the transition from the acute to the chronic phase of severe head injury in order to determine patterns of change in relation to neurological outcome. We measured CBF with stable xenon-enhanced computed tomography (Xe-CT) in 20 consecutive patients at 1, 2, 3, 4, and 6 weeks after severe head injury, and analyzed the relation between the pattern of change in CBF and neurological outcome at 6 months after injury. CBF values were significantly lower in the brain-injured patients than in 14 healthy volunteers, except at 3 weeks after injury, when CBF increased in the patients to a value that did not differ significantly from that in the normal volunteers. We therefore focused on the change in CBF at 3 weeks after injury. We separated the 20 brain-injured patients into two subgroups, of which the first (subgroup A) consisted of nine patients whose CBF had returned to normal by week 3 post-injury, while the second (subgroup B) consisted of 11 patients whose CBF was subnormal at week 3 post-injury. CBF was significantly higher in subgroup A than in subgroup B at 2 weeks post-injury (p < 0.05). CBF in subgroup B remained significantly lower than that in subgroup A throughout the study period. At 6 months post-injury, subgroup A had a significantly better neurological outcome than did subgroup B (p < 0.05). We conclude that patients whose CBF returns to normal at 2-3 weeks following severe traumatic brain injury after being abnormally low in the acute phase of injury can be expected to achieve a good neurological outcome.
authors.affiliation: Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine, 2-15 Yamadaoka, Suita, Osaka 565-0871, Japan. yinoue@hp-emerg.med.osaka-u.ac.jp
authors.forename: Yoshiaki
authors.initials: Y
authors.lastname: Inoue
authors.forename: Tadahiko
authors.initials: T
authors.lastname: Shiozaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Tasaki
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hayakata
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Ikegawa
authors.forename: Kazuhisa
authors.initials: K
authors.lastname: Yoshiya
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Fujinaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Tanaka
authors.forename: Takeshi
authors.initials: T
authors.lastname: Shimazu
authors.forename: Hisashi
authors.initials: H
authors.lastname: Sugimoto
mesh_terms: D000293:Adolescent; D000328:Adult; D001921:Brain / Q000098:blood supply*; D001930:Brain Injuries / Q000209:etiology / Q000503:physiopathology*; D020208:Brain Injury, Chronic / Q000503:physiopathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D006259:Craniocerebral Trauma / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D014978:Xenon
chemical_list: D014978:Xenon