OBJECT: This study was designed to investigate the incidence of early abnormalities in the cerebral circulation after head injury by relating the results of the initial computerized tomography (CT) scan with transcranial Doppler (TCD) ultrasound readings to see if the side of injury and the outcome can be predicted by using these modalities. METHODS: Transcranial Doppler ultrasound measurements were obtained in the emergency room in 22 head-injured patients less than 3 hours after injury. The middle cerebral artery (MCA) was insonated using a standard technique. The TCD measurements in each MCA were examined individually; of 39 measurements, 22 (56%) showed a low mean blood flow velocity, 27 (69%) demonstrated a high pulsatility index (PI), and 18 (46%) showed both abnormalities. The side of the cerebrovascular abnormality measured by TCD ultrasound did not appear to be an accurate predictor of the side of the injury as determined on the initial CT scan. Of 13 patients in whom either a space-occupying hematoma or signs of swelling were shown on the initial CT scan, 10 (77%) had an increased PI in one or both MCAs, which is an indication of high flow resistance. CONCLUSIONS: Transcranial Doppler ultrasound examinations performed while patients are in the emergency room may have a role in determining treatment priorities, especially in those with multiple injuries.
OBJECT: This study was designed to investigate the incidence of early abnormalities in the cerebral circulation after head injury by relating the results of the initial computerized tomography (CT) scan with transcranial Doppler (TCD) ultrasound readings to see if the side of injury and the outcome can be predicted by using these modalities. METHODS: Transcranial Doppler ultrasound measurements were obtained in the emergency room in 22 head-injured patients less than 3 hours after injury. The middle cerebral artery (MCA) was insonated using a standard technique. The TCD measurements in each MCA were examined individually; of 39 measurements, 22 (56%) showed a low mean blood flow velocity, 27 (69%) demonstrated a high pulsatility index (PI), and 18 (46%) showed both abnormalities. The side of the cerebrovascular abnormality measured by TCD ultrasound did not appear to be an accurate predictor of the side of the injury as determined on the initial CT scan. Of 13 patients in whom either a space-occupying hematoma or signs of swelling were shown on the initial CT scan, 10 (77%) had an increased PI in one or both MCAs, which is an indication of high flow resistance. CONCLUSIONS: Transcranial Doppler ultrasound examinations performed while patients are in the emergency room may have a role in determining treatment priorities, especially in those with multiple injuries.
Authors: Adam R Militana; Manus J Donahue; Allen K Sills; Gary S Solomon; Andrew J Gregory; Megan K Strother; Victoria L Morgan Journal: Brain Imaging Behav Date: 2016-06 Impact factor: 3.978
Authors: Paul Jaffres; Julien Brun; Philippe Declety; Jean-Luc Bosson; Bertrand Fauvage; Almuth Schleiermacher; Affif Kaddour; Daniel Anglade; Claude Jacquot; Jean-Francois Payen Journal: Intensive Care Med Date: 2005-04-16 Impact factor: 17.440
Authors: Benjamin Y Tan; Adriel Z Leong; Aloysius S Leow; Nicholas J Ngiam; Bridget S Ng; Manasi Sharma; Leonard L Yeo; Philip A Seow; Chiew S Hong; Young H Chee; Jintao Chen; Zhengdao Du; Lily Y Wong; Amit Batra; Nabin Sarkar; Hock-Luen Teoh; Roger C Ho; Vijay K Sharma Journal: PLoS One Date: 2019-01-07 Impact factor: 3.240
Authors: Danilo Cardim; C Robba; M Bohdanowicz; J Donnelly; B Cabella; X Liu; M Cabeleira; P Smielewski; B Schmidt; M Czosnyka Journal: Neurocrit Care Date: 2016-12 Impact factor: 3.210
Authors: Jacob Glaser; Matthew Vasquez; Cassandra Cardarelli; Samuel Galvagno; Deborah Stein; Sarah Murthi; Thomas Scalea Journal: Trauma Surg Acute Care Open Date: 2016-09-28