Cerebral hemodynamic changes gauged by transcranial Doppler ultrasonography in patients with posttraumatic brain swelling treated by surgical decompression

Journal of Neurosurgery
Edson Bor-Seng-ShuRaul Marino

Abstract

The use of decompressive craniectomy has experienced a revival in the previous decade, although its actual benefit on patients' neurological outcome remains the subject of debate. A better understanding of the intracranial pressure dynamics, as well as of the metabolic and hemodynamic brain processes, may be useful in assessing the effect of this surgery on the pathophysiology of the swollen brain. The aim of this study was to use transcranial Doppler (TCD) ultrasonography to examine the hemodynamic changes in the brain after decompressive craniectomy in patients with head injury, in addition to examining the relationship between such hemodynamic changes and the patient's neurological outcome. Nineteen patients presenting with traumatic brain swelling and cerebral herniation syndrome who had undergone decompressive craniectomy with dural expansion were studied prospectively. The TCD ultrasonography measurements were performed bilaterally in both the middle cerebral artery (MCA) and in the distal portion of the cervical internal carotid artery (ICA) immediately prior to and after surgical decompression. After surgery, the mean blood flow velocity (BFV) rose to 175 +/- 209% of preoperative values in the MCA of the operated side, ...Continue Reading

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Citations

Sep 22, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Ha Son NguyenAaron A Cohen-Gadol
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