Intrahospital transport of patients with TBI may lead to a significant increase in ICP, dynamic PRx, and decreased CPP. The results suppose that the decision to perform brain CT in comatose patients with TBI should be carefully considered by clinicians.
In patients with complications due to PTE TBI, HD-tDCS causes a significant increase in CBV, CBF and a decrease in the average MTT, suggesting better oxygen delivery to tissue.
CVR in patients with CTBI is significantly increased compared to the normal value and remains elevated after evacuation of hematoma in the perifocal zone compared to the symmetrical zone in the contralateral hemisphere. This is indicative of certain correlation between the mechanisms of cerebral blood flow autoregulation and maintaining CVR.
The aim of this work was comparison of two algorithms for perfusion computed tomography (PCT) data analysis for evaluation of cerebral microcirculation in the perifocal zone of chronic subdural hematoma (CSDH). Twenty patients with CSDH after polytrauma were included in the study. The same PCT data were assessed quantitatively in cortical brain region beneath the CSDH (zone 1), and in the corresponding contralateral brain hemisphere (zone 2) without and with the use of perfusion calculation mode excluding vascular pixel ‘Remote Vessels’ (RV); 1st and 2nd analysis method, respectively. Comparison with normal values for perfusion indices in the zone 1 by the 1st analysis method showed a significant (p <0.01) increase in CBV and CBF, and no significant increase in MTT and TTP. Use of the RV mode (2nd analysis method) showed no statistically reliable change of perfusion parameters in the microcirculatory blood flow of the 2nd zone. Maintenance of microcirculatory blood flow perfusion reflects the preservation of cerebral blood flow autoregulation in patients with CSDH.
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