[The application of transcranial Doppler in the evaluation of brain function in deeply comatose patients].
OBJECTIVE
To study the cerebral blood flow changes in irreversible comatose patients and investigate the correlation between the results of transcranial Doppler (TCD) and clinical evaluation of brain function.


METHODS
TCD studies were performed in 92 patients who were excluded from the possibility of reversible coma and all of them had Glasgow Coma Scale of 3. Their brain stem reflections all disappeared. Detection of the blood flow in bilateral middle cerebral arteries was carried out through temporal window in all the patients and in 42 of the 92 cases the blood flow of the basilar artery was detected through occipital or peri-occipital window. Bilateral middle cerebral artery were taken as the main arteries for evaluation. The positive standard is the appearance of one of the following characteristic blood flow, i.e. brief systolic forward flow or systolic spikes and diastolic reverse flow, brief systolic forward flow or systolic spikes and no diastolic flow and no detectable flow signals. The examination was repeated after 12 h.


RESULTS
68 cases were positive in the initial examination (73.9%) and 74 cases were positive after 12 h (80.4%).


CONCLUSIONS
TCD can be an effective and objective index in the evaluation of irreversible termination of brain function.
Luo
Ben-yan
BY
Department of Neurology, First Affiliated Hospital of Medical College, Zhejiang University, Hangzhou 310003, China. luobenyan@zju.edu.cn
Zhang
Ling-ju
LJ
Jiang
Mei-yan
MY
Wang
Jian-wen
JW
Qiu
Yun-qing
YQ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000503:physiopathology*; D002560:Cerebrovascular Circulation; D003128:Coma / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D020768:Middle Cerebral Artery / Q000000981:diagnostic imaging*; D017585:Ultrasonography, Doppler, Transcranial