title: Early cerebral circulation disturbance in patients suffering from different types of severe traumatic brain injury: a xenon CT and perfusion CT study.
abstract: BACKGROUND
  Traumatic brain injury (TBI) is widely known to cause dynamic changes in cerebral blood flow (CBF). In particular, secondary brain insults have been reported to decrease CBF. The purpose of this study was to clarify the cerebral circulation in different types of TBI.
  
  
  METHODS
  Sixty-nine patients with TBI were divided into four groups, the subdural hematoma group, the contusion/intracerebral hematoma group, the diffuse axonal injury group, and the diffuse brain swelling group. In these patients, we simultaneously performed Xe-CT and perfusion CT to evaluate the cerebral circulation on post-injury days 1-3. We measured CBF using Xe-CT and mean transit time using perfusion CT and calculated the cerebral blood volume using the AZ-7000 W98 computer system.
  
  
  RESULTS
  There were no significant differences in the Glasgow Coma Scale score on arrival or the Glasgow Outcome Scale score between the groups. The patients who had suffered focal TBI displayed more significant cerebral circulation disturbances than those that had suffered diffuse TBI. We were able to evaluate the cerebral circulation of TBI patients using these parameters.
  
  
  CONCLUSIONS
  Moderate hypothermia therapy, which decreases CBF, the cerebral metabolic rate oxygen consumption (CMRO2), and intracranial pressure might be effective against the types of TBI accompanied by cerebral circulation disturbance. We have to use all possible measures including hypothermia therapy to treat severe TBI patients according to the type of TBI that they have suffered.
authors.affiliation: Department of Critical Care Center, Toho University Medical Center, Tokyo, Japan. mhonda@toho-u.ac.jp
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Honda
authors.forename: Shigeru
authors.initials: S
authors.lastname: Sase
authors.forename: Kyosuke
authors.initials: K
authors.lastname: Yokota
authors.forename: Ryo
authors.initials: R
authors.lastname: Ichibayashi
authors.forename: Katsunori
authors.initials: K
authors.lastname: Yoshihara
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Masuda
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Uekusa
authors.forename: Jun
authors.initials: J
authors.lastname: Nomoto
authors.forename: Nobuo
authors.initials: N
authors.lastname: Sugo
authors.forename: Taichi
authors.initials: T
authors.lastname: Kishi
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Seiki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001930:Brain Injuries / Q000145:classification / Q000175:diagnosis* / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D005260:Female; D015600:Glasgow Coma Scale; D006801:Humans; D008297:Male; D008875:Middle Aged; D012039:Regional Blood Flow; D014055:Tomography, Emission-Computed; D014978:Xenon; D055815:Young Adult
chemical_list: D014978:Xenon