Surgical evacuation of acute subdural hematoma improves cerebral hemodynamics in children: a transcranial Doppler evaluation

Abstract

Children with acute bilateral HSD have a high incidence of increased intracranial pressure as assessed by TCD. Surgical evacuation improves cerebral hemodynamics. TCD could be used for assessing the need for, and the efficiency of surgical drainage.

New Transcranial Doppler Index in Infants with Hydrocephalus: Transsystolic Time in Clinical Practice

“…In recent literature, TCD parameters are investigated in patients with vertigo, IIH, NPH, ischemic stroke, adult hydrocephalus, virus encephalitis and severe brain trauma (Bakker et al 2002;Gur et al 2007;Miranda et al 2006;Rainov et al 2000;Voulgaris et al 2005;Wang et al 2005;Meyer et al 2005;Mandera et al 2002). In infants with hydrocephalus, CBF reduction is approximately 50% (Leliefeld et al 2008), which is caused by distortion of the periventricular vessels consequential to ventricular enlargement (Del Bigio and Bruni 1988;Plets and van den Bergh 1973;Leliefeld et al 2008), elevated sinus compliance, venous collapse (Bateman et al 2007), venous sinus stenosis (Bateman 2008) or increase in ICP, which causes an increase in CBF resistance by compression of the arteriolar, venular and venous sinus system (Leliefeld et al 2008;Shapiro et al 1985).…”

Post-traumatic massive acute subdural haematoma in a child following trivial fall

“…(3,6) Indications for surgical evacuation are based upon clinical and radiological features (4) and correct diagnosis and early surgical intervention combined with therapeutic measures improves cerebral hemodynamics (4) and ensures a favorable outcome in majority of the cases. (1,4,5) However in children with ASDH there is a high incidence of increased intracranial pressure. (4) These findings of cerebral oedema in children with ASDH signifies severe injury and associated poor neurological status further make the outcome worse as in present case.…”

Pathophysiology and Treatment of Severe Traumatic Brain Injuries in Children

“…The use of TCD to evaluate increased ICP is limited in children (Melo et al, 2011;Meyer et al, 2005) and has previously been used to evaluate cerebral vasospasms (Trabold et al, 2004) and cerebral autoregulation (Vavilala et al, 2004). This non-invasive method may be useful as screening tool in early resuscitation because it can be used in children with coagulation disorders and those with critical injuries prior to computed tomography (CT) scan (Melo et al, 2011).…”