The cAC in TBI gets significantly lower compared with the conditional norm (p < 0.001). After removal of the intracranial hematomas, compliance in the perifocal zone remains much lower (р = 0.017) compared with compliance of the other brain hemisphere.

The aim was to investigate the feasibility of simultaneous comparison of cerebral circulation in major vessels and microvasculature in patients suffering traumatic brain injury (TBI) with or without intracranial hematomas (IH).Methods.-170 patients were divided into two groups: Group 1 -diffuse TBI (75 patients); and Group 2 -TBI with IH (95 patients: 18 epidural, 65 subdural and 12 multiple). Perfusion computed tomography (PCT) for assessment of volumetric cerebral blood flow (CBF) was done 2-15days after admission to hospital. Simultaneous assessment of cerebral blood flow velocity (CBFV) in both middle cerebral arteries was done by transcranial Doppler.Results.-In patients with diffuse TBI, CBF had statistically valid correlations with CBFV (r = 0.28, p = 0.0149 on the left side; r = 0.382, p = 0.00075 on the right side). In patients with TBI and IH, the analysis did not reveal any reliable correlations between the CBFV and CBF velocity in the temporal lobes, either on the side of the removed IH or on the opposite side.

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Zero-fl ow pressure (ZFP) is an important parameter of a microcirculation. The aim is to determine the status of the ZFP at concomitant traumatic brain injury with and without the development of intracranial hematomas. Material and Methods:The results of the treatment of 80 patients with severe head injury and polytrauma was studied. M:F -44:36. Their average age was 34.3 ± 14.5 years (min 15: max 73). Depending on the presence of intracranial hemorrhages the patients were divided into 2 groups. Wakefulness according to Glasgow Coma Score (GCS) was 10.4 ± 2.6 in the 1st group and 10.6 ± 2.8 in the 2nd group. The Injury Severity Score (ISS) was 32 ± 8 in the 1st group and 31 ± 11 in the 2nd group. Epidural hematomas were revealed in the 2nd group in 7 patients, subdural hematomas in 27 persons and multiple hematomas in 4 sufferers. All the sufferers were operated within the fi rst 3 days. During the fi rst day 30 patients (78.9%) were operated.All the patients were subjected to the transcranial Doppler of the both middle cerebral arteries and the evaluation of the mean arterial pressure. Based on the data obtained the cerebral perfusion pressure and the ZFP were calculated. The comparisons between the groups were performed by using the Student's t-criterion. Results:There was no signifi cant difference in ZFP between the left side and the right side in 1 st group (46.88±14.05 mmHg vs. 45.44±10.73 mmHg, respectively, t=0.45; р=0.65) The average ZFP values in each of the groups (with or without hematomas) appeared to be statistically signifi cantly higher than a mean value in control group (32,9 ± 3,6 mmHg, р<0.01). The intergroup comparison of the ZFP showed a statistically reliable increase in its level in the 2nd group on the side of the removed hematoma as compared with opposite side (56.02±21.68 mmHg vs. 45.43±16.71 mmHg, respectively, t=2.38; р=0.019p=0,019).