Hyperemia following traumatic brain injury: relationship to intracranial hypertension and outcome

Journal of Neurosurgery
D F KellyD P Becker

Abstract

The role of posttraumatic hyperemia in the development of raised intracranial pressure (ICP) has important pathophysiological and therapeutic implications. To determine the relationship between hyperemia (cerebral blood flow (CBF) > 55 ml/100 g/minute), intracranial hypertension (ICP > 20 mm Hg), and neurological outcome, 193 simultaneous measurements of ICP and CBF (xenon-133 method) were obtained in 59 patients with moderate and severe head injury. Hyperemia was associated with an increased incidence of simultaneous intracranial hypertension compared to nonhyperemic CBF measurements (32.2% vs. 21.6%, respectively; p < 0.059). However, in 78% of blood flow studies in which ICP was greater than 20 mm Hg, CBF was less than or equal to 55 ml/100 g/minute. At least one episode of hyperemia was documented in 34% of patients, all of whom had a Glasgow Coma Scale (GCS) score of 9 or below. In 12 individuals with hyperemia without simultaneous intracranial hypertension, ICP was greater than 20 mm Hg for an average of 11 +/- 16 hours and favorable outcomes were seen in 75% of patients. In contrast, in eight individuals with hyperemia and at least one episode of hyperemia-associated intracranial hypertension, ICP was greater than 20 mm ...Continue Reading

References

Mar 1, 1975·Lancet·B Jennett, M Bond
Sep 1, 1979·Journal of Neurosurgery·Walter D ObristT W LANGFITT
Jan 1, 1992·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·T KawamataD P Becker
Jul 10, 1992·Brain Research·B J Andersen, A Marmarou
Jul 1, 1992·Stroke; a Journal of Cerebral Circulation·J Klingelhöfer, D Sander
Jul 1, 1992·Journal of Neurology, Neurosurgery, and Psychiatry·C S RobertsonR G Grossman
Mar 1, 1992·Journal of Neurosurgery·Y KurodaR Bullock
Feb 1, 1990·Journal of Neurosurgery·J L JaggiT W LANGFITT
Feb 1, 1986·Journal of Neurosurgery·K MesseterE Ryding
Jul 1, 1987·Stroke; a Journal of Cerebral Circulation·R Aaslid
Dec 1, 1974·Journal of Neurology, Neurosurgery, and Psychiatry·C FieschiM Rossanda
Jan 1, 1982·Journal of Neurosurgery·T A GennarelliL H Pitts
Mar 1, 1981·Journal of Neurosurgery·J D MillerD P Becker
Dec 1, 1995·Journal of Neurosurgery·M J RosnerA H Johnson
Aug 1, 1995·Journal of Neurosurgery·D E SakasG M Teasdale
Jun 1, 1995·Stroke; a Journal of Cerebral Circulation·F P TiecksD W Newell
Jan 1, 1995·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·K A CongerH P Hetherington
Feb 1, 1994·Neurology·A K SelkyR D Yee
Jul 1, 1965·Neurology·T W LANGFITTN F KASSELL

Citations

May 7, 2002·Journal of Neurotrauma·Ulrich-Wilhelm ThomaleJohn F Stover
Jan 25, 2005·Journal of Neurotrauma·Hilaire J ThompsonTracy K McIntosh
Jul 19, 2001·Neurologia Medico-chirurgica·E UrasakiY Aragaki
Apr 1, 1997·Journal of Neurosurgery·D F KellyD P Becker
Jul 21, 1999·Journal of Neurosurgery·M CormioC S Robertson
Oct 19, 2000·Lancet·J Ghajar
Jun 29, 2004·Radiology·Max WintermarkRené Chioléro
May 29, 2012·Journal of Neuroradiology. Journal De Neuroradiologie·Robson Luis AmorimManoel Jacobsen Teixeira
Nov 3, 2015·The Journal of Surgical Research·Che-Chuan WangBor-Shyh Lin
Jun 15, 2004·Brain Pathology·L CherianC S Robertson
Jul 1, 1997·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·J V Rosenfeld
Sep 10, 2013·Diagnostic and Interventional Imaging·A KrainikJ Warnking
Apr 29, 2016·Journal of Intensive Care·Kosaku Kinoshita
Jun 18, 2016·Current Neurology and Neuroscience Reports·Omar S AkbikHoward Yonas
Oct 6, 2001·Arquivos de neuro-psiquiatria·J Cruz
Jul 24, 2014·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Leif ØstergaardMads Rasmussen
Feb 11, 2010·Journal of Cerebral Blood Flow and Metabolism : Official Journal of the International Society of Cerebral Blood Flow and Metabolism·Riikka ImmonenOlli Gröhn
Jun 19, 2003·Pediatric Critical Care Medicine : a Journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies·Patrick M. KochanekLarry W. Jenkins
Jul 12, 2008·International Anesthesiology Clinics·Michael T Alkire
Nov 29, 2005·Physiological Measurement·I R ChambersA Sitkauskas
Aug 1, 2019·Therapeutic Hypothermia and Temperature Management·Max GaaschRaimund Helbok
Apr 12, 2000·Journal of Neurophysiology·L CherianC S Robertson
Jan 9, 2001·Journal of Neurosurgical Anesthesiology·E M KerrJ Wilberger
Jul 16, 2019·Journal of Neurosurgical Anesthesiology·François MathieuFrederick A Zeiler
Apr 1, 2005·British Journal of Neurosurgery·R B PaneraiD H Evans
Aug 5, 2017·Frontiers in Neurology·Daniel Agustín GodoyFrancisco Murillo-Cabezas
Nov 19, 2002·The Journal of Trauma·Matthew J Fabian, Kenneth G Proctor
May 20, 2018·Journal of Neuroinflammation·Yang-Wuyue LiuShuang-Shuang Dai
May 19, 2017·Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine·Shalini Nair, Ramanan Rajagopal

Related Concepts

Mild Traumatic Brain Injury
Cerebrovascular Circulation
Reactive Hyperemia
Hypertensive Disease
Intracranial Pressure

Related Feeds

Brain Injury & Trauma

brain injury after impact to the head is due to both immediate mechanical effects and delayed responses of neural tissues.