title: Cerebral blood flow velocity changes and the value of the pulsatility index post decompressive craniectomy.
abstract: Decompressive craniectomy (DC) is used to relieve intractable intracranial hypertension and/or to prevent or reverse cerebral herniation. Significant controversy exists on selection of candidates, timing of the procedure and neurologic outcomes. Furthermore, the cerebral hemodynamic consequences post-DC have been researched only recently. We report on two consecutive patients who underwent DC in our institution and reviewed the literature on cerebral blood flow changes post-craniectomy. One patient had unilateral DC and the second had a suboccipital decompression (SOC). Cerebral blood flow velocities (FV) and pulsatility indices (PI) were recorded via transcranial Doppler (TCD). To our knowledge, this is the first report on FV/PI monitoring after SOC. TCD is a readily available, non-invasive test. The PI may provide useful information regarding timing and effectiveness of DC.
authors.affiliation: Neurosciences Intensive Care Unit, Medical University of South Carolina, Charleston, SC 29425, USA. lazaridi@musc.edu
authors.forename: Christos
authors.initials: C
authors.lastname: Lazaridis
authors.forename: Stacia M
authors.initials: SM
authors.lastname: DeSantis
authors.forename: Alex W
authors.initials: AW
authors.lastname: Vandergrift
authors.forename: Vibhor
authors.initials: V
authors.lastname: Krishna
mesh_terms: D001783:Blood Flow Velocity; D020201:Brain Hemorrhage, Traumatic / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D001930:Brain Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D002560:Cerebrovascular Circulation / Q000502:physiology*; D056424:Decompressive Craniectomy / Q000379:methods*; D006801:Humans; D007427:Intracranial Pressure / Q000502:physiology; D008297:Male; D008875:Middle Aged; D011673:Pulsatile Flow / Q000502:physiology*; D015898:Tomography Scanners, X-Ray Computed; D017585:Ultrasonography, Doppler, Transcranial