Prognostic value of Pulsatility Index in acute intracerebral hemorrhage

Martí‐Fàbregas, Joan; Belvís, R.; Guardia, E.; Cocho, Dolores; Muñoz, J.; Marruecos, Laura; Martí-Vilalta, Josep-Lluis

doi:10.1212/01.wnl.0000090520.67254.14

Cited by 52 publications

(47 citation statements)

References 48 publications

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“…60 Transcranial Doppler sonography has the potential to assess mass effect and track ICP changes. 61 Increased ICP and decreased CPP give rise to typical changes in the Doppler waveform obtained by transcranial insonation (ie, a decrease in diastolic velocity and an increase in the pulsatility index). Information on the relation of radiological data to 1 or more specific transcranial Doppler variables and on the clinical utility of radiological data is still sparse.…”

Section: Monitoring Of Neurological and Cardiopulmonary Functionmentioning

confidence: 99%

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Broderick¹,

Connolly²,

Feldmann³

et al. 2007

Circulation

314

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Section: Monitoring Of Neurological and Cardiopulmonary Functionmentioning

confidence: 99%

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Broderick¹,

Connolly²,

Feldmann³

et al. 2007

Circulation

314

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“…Intracerebral hemorrhage (ICH) is associated with considerable morbidity and mortality, with estimates of 30-day mortality ranging from 10 to 52% 2,24) . It accounts for approximately 10-20% of all strokes 6) .…”

Section: Introductionmentioning

confidence: 99%

Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

Chung

Won

Kwon

et al. 2009

J Korean Neurosurg Soc

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Objective : It has been suggested that elevated cardiac troponin T (cTnT) level is a marker of increased risk of mortality in acute ischemic stroke and subarachnoid hemorrhage (SAH). However, the association of serum cTnT level and prognosis of intracerebral hemorrhage (ICH) has been sparsely investigated. The aim of this study was to identify the relationship between cTnT level and the outcome in patients with spontaneous ICH. Methods : We retrospectively investigated 253 patients identified by a database search from records of patients admitted in our department for ICH between January 1, 2003 and December 31, 2007. The patients were divided into 2 groups; the patients in group 1 (n=225) with serum cTnT values of 0.01 ng/mL or less, and those in group 2 (n=28) with serum cTnT values greater than 0.01 ng/mL. Results : The serum cTnT level was elevated in 28 patients. There were significant differences in sex, hypertension, creatine kinase-myocardial band, midline shift, side of hematoma, and presence of intraventricular hemorrhage between the 2 groups. Logistic regression analysis identified the level of consciousness on admission, cTnT and midline shift as independent predictors of hospital mortality. Conclusion : Theses results suggest that increased serum cTnT level at admission is associated with in-hospital mortality and the addition of a serum cTnT assay to routine admission testing should be considered in patients with ICH.

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“…In a prospective study of forty-eight patients with an acute spontaneous supratentorial intracranial hemorrhage, the PI from the unaffected hemisphere was correlated with mortality (OR 2.3, CI 0.92 to 5.72, p = 0.07). A cutoff for PI from the unaffected hemisphere of 1.75 showed a specificity of 94% and a sensitivity of 80% as a predictor of death at 30 days [30]. Promising new applications using ultrasound technology to estimate ICP noninvasively have been described, but need to be validated in large clinical setting [31].…”

Section: Transcranial Doppler (Tcd) Ultra-sonographymentioning

confidence: 99%

Measurement and Management of Increased Intracranial Pressure

Sadoughi

Rybinnik

Cohen

2013

TOCCMJ

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Increased intracranial pressure (ICP) is a serious complication of a variety of neurologic injuries and is a major challenge in intensive care units. The most common causes of increased ICP are: traumatic brain injury (TBI), stroke, neoplasms, hydrocephalus, hepatic encephalopathy, CNS venous return impairment, encephalitis, and abscesses. Prompt diagnosis and intensive monitoring and therapy of this condition are essential for successful management of this potentially devastating condition. Recent technical innovations in neuromonitoring may allow for improvement in morbidity and mortality rates attributable to elevated ICP. Normal ICP ranges from 3-15 mmHg. In routine intensive care unit (ICU) practice, the goal of ICP management is to maintain levels below 20 mmHg. Noninvasive and metabolic monitoring of ICP including imaging-clinical examination has been studied and suggested to be as efficient as the care based on invasive ICP monitoring; however its application in clinical practice is to be established. Raised intracranial pressure correlates with decreased survival and is often the only remediable element of brain pathology. While elimination of the cause of elevated ICP remains the definitive approach, there are maneuvers that should be used to decrease ICP urgently. Surgical decompression of mass effect may rapidly improve ICP elevation. Osmolar therapy, maintenance of euvolemia, cerebral metabolic suppression, and temperature control are part of the advanced management of elevated ICP.

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Prognostic value of Pulsatility Index in acute intracerebral hemorrhage

Abstract: The PI of the unaffected hemisphere may be a predictor of death in acute ICH. These findings suggest that intracranial hypertension is the most likely cause of death in most patients with ICH.

Cited by 52 publications

References 48 publications

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Initial Troponin Level as a Predictor of Prognosis in Patients with Intracerebral Hemorrhage

Measurement and Management of Increased Intracranial Pressure

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