Posttraumatic Refractory Intracranial Hypertension and Brain Herniation Syndrome: Cerebral Hemodynamic Assessment before Decompressive Craniectomy
Joint Authors
Paiva, Wellingson Silva
Teixeira, Manoel Jacobsen
Figueiredo, Eberval G.
Fujimoto, Yasunori
Fonoff, Erich Talamoni
Andrade, Almir Ferreira de
Bor-Seng-Shu, Edson
Source
Issue
Vol. 2013, Issue 2013 (31 Dec. 2013), pp.1-7, 7 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2013-11-27
Country of Publication
Egypt
No. of Pages
7
Main Subjects
Abstract EN
Background.
The pathophysiology of traumatic brain swelling remains little understood.
An improved understanding of intracranial circulatory process related to brain herniation may have treatment implications.
Objective.
To investigate the cerebral hemodynamic changes associated with brain herniation syndrome due to traumatic brain swelling.
Methods.
Nineteen head-injured patients with evidence of refractory intracranial hypertension and transtentorial herniation were prospectively studied.
Cerebral hemodynamic assessment by transcranial Doppler (TCD) ultrasonography was performed prior to decompressive craniectomy.
Patients and their cerebral hemispheres were classified according to TCD-hemodynamic patterns, and the data correlated with neurological status, midline shift on CT scan, and Glasgow outcome scale scores at 6 months after injury.
Results.
A wide variety of cerebral hemodynamic findings were observed.
Ten patients (52.7%) presented with cerebral oligoemia, 3 patients (15.8%) with cerebral hyperemia, and 6 patients with nonspecific circulatory pattern.
Circulatory disturbances were more frequently found in the side of maximal cerebral swelling than in the opposite side.
Pulsatility index (PI) values suggested that ICP varied from acceptable to considerably high; patients with increased PI, indicating higher microvascular resistance.
No correlation was found between cerebral hemodynamic findings and outcome.
Conclusions.
There is a marked heterogeneity of cerebral hemodynamic disturbances among patients with brain herniation syndrome.
American Psychological Association (APA)
Bor-Seng-Shu, Edson& Paiva, Wellingson Silva& Figueiredo, Eberval G.& Fujimoto, Yasunori& Andrade, Almir Ferreira de& Fonoff, Erich Talamoni…[et al.]. 2013. Posttraumatic Refractory Intracranial Hypertension and Brain Herniation Syndrome: Cerebral Hemodynamic Assessment before Decompressive Craniectomy. BioMed Research International،Vol. 2013, no. 2013, pp.1-7.
https://search.emarefa.net/detail/BIM-1030875
Modern Language Association (MLA)
Bor-Seng-Shu, Edson…[et al.]. Posttraumatic Refractory Intracranial Hypertension and Brain Herniation Syndrome: Cerebral Hemodynamic Assessment before Decompressive Craniectomy. BioMed Research International No. 2013 (2013), pp.1-7.
https://search.emarefa.net/detail/BIM-1030875
American Medical Association (AMA)
Bor-Seng-Shu, Edson& Paiva, Wellingson Silva& Figueiredo, Eberval G.& Fujimoto, Yasunori& Andrade, Almir Ferreira de& Fonoff, Erich Talamoni…[et al.]. Posttraumatic Refractory Intracranial Hypertension and Brain Herniation Syndrome: Cerebral Hemodynamic Assessment before Decompressive Craniectomy. BioMed Research International. 2013. Vol. 2013, no. 2013, pp.1-7.
https://search.emarefa.net/detail/BIM-1030875
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1030875