Comparative Analysis of Simultaneous Transcranial Doppler and Perfusion Computed Tomography for Cerebral Perfusion Evaluation in Patients with Traumatic Brain Injury

Abstract

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.

Hemodynamic predictors of early neurological deterioration and clinical outcome after endovascular treatment in large artery occlusion

“…Aaslid et al used TCD in 1982 to monitor the MFV of major intracranial arteries such as the MCA to estimate CBF [ 14 ], and TCD assessment of cerebral perfusion is currently used in several fields [ [15] , [16] , [17] , [18] ]. In carotid endarterectomy, a significant increase in flow velocity in the affected vessel postoperatively compared to preoperatively suggests the occurrence of hyperperfusion [ 19 ].…”

Multimodal and autoregulation monitoring in the neurointensive care unit

“…TCD derived CBFV measurements also provide useful information regarding the competency of cerebral perfusion, with low values suggestive of oligemia, and have been linearly correlated with CBF using computed tomography perfusion (CTP) in patients with diffuse traumatic injury patterns ( 154 ). A low-flow state defined as MCA MFV below 40 cm/s, occurs in over half of TBI patients during the first 24 h after injury, most often ipsilateral to focal pathology and correlates with the burden of cerebral hypoxia (PbtO 2 <20 mmHg) ( 155 , 156 ).…”