Imaging of cerebral blood flow and metabolism in brain injury in the ICU.
The heterogeneity of the initial insult and subsequent pathophysiology has made both the study of human head injury and design of randomised controlled trials exceptionally difficult. The combination of multimodality bedside monitoring and functional brain imaging positron emission tomography (PET) and magnetic resonance (MR), incorporated within a Neurosciences Critical Care Unit, provides the resource required to study critically ill patients after brain injury from initial ictus through recovery from coma and rehabilitation to final outcome. Methods to define cerebral ischemia in the context of altered cerebral oxidative metabolism have been developed, traditional therapies for intracranial hypertension re-evaluated and bedside monitors cross-validated. New modelling and analytical approaches have been developed.
Pickard
J D
JD
Wolfson Brain Imaging Centre, University of Cambridge, Addenbrookes Hospital, Cambridge, UK. idpsecretary@medschl.can.ac.uk
Hutchinson
P J
PJ
Coles
J P
JP
Steiner
L A
LA
Johnston
A J
AJ
Fryer
T D
TD
Coleman
M R
MR
Smielewski
P
P
Chatfield
D A
DA
Aigbirhio
F
F
Williams
G B
GB
Rice
K
K
Clark
J C
JC
Salmond
C H
CH
Sahakian
B J
BJ
Bradley
P G
PG
Carpenter
T A
TA
Salvador
R
R
Pena
A
A
Gillard
J H
JH
Cunningham
A S
AS
Piechnik
S
S
Czosnyka
M
M
Menon
D K
DK
D000818:Animals; D015415:Biomarkers / Q000032:analysis; D001783:Blood Flow Velocity; D001921:Brain / Q000098:blood supply / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology; D001930:Brain Injuries / Q000175:diagnosis* / Q000378:metabolism; D001931:Brain Mapping / Q000379:methods*; D002560:Cerebrovascular Circulation; D003422:Critical Care / Q000379:methods*; D004867:Equipment Design; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D007362:Intensive Care Units; D008279:Magnetic Resonance Imaging / Q000379:methods*; D010100:Oxygen / Q000378:metabolism; D010101:Oxygen Consumption; D049268:Positron-Emission Tomography / Q000379:methods*; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D006113:United Kingdom
D015415:Biomarkers; D010100:Oxygen