Transcranial doppler recordings in raised intracranial pressure

Homburg, A.-M.; Jakobsen, Mogens; Enevoldsen, E.

doi:10.1111/j.1600-0404.1993.tb04142.x

Cited by 131 publications

(45 citation statements)

References 18 publications

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“…Below a CPP threshold of 70 mm Hg, a progressive increase was documented in the TCD PI (peak systolic velocity -enddiastolic velocity/mean fl ow velocity). Homburg et al [36] found that the PI changes by 2.4% per 1 mm Hg of ICP.…”

Section: Detection Of Increased Icpmentioning

confidence: 98%

Advances in transcranial doppler ultrasonography

Tsivgoulis¹,

Alexandrov²,

Sloan

2008

Curr Neurol Neurosci Rep

157

127

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Transcranial Doppler ultrasonography (TCD) is the only noninvasive real-time neuroimaging modality for the evaluation of characteristics of blood flow in basal intracerebral vessels that adds physiologic information to structural imaging. TCD has been rapidly evolving from a simple noninvasive diagnostic tool to an imaging modality with a broad spectrum of clinical applications. In acute stroke, TCD can provide rapid information about vascular stenosis and occlusion, the hemodynamic status of the cerebral circulation, and real-time monitoring of recanalization. Extended applications such as vasomotor reactivity testing, emboli monitoring, and right-to-left shunt detection help clinicians ascertain stroke mechanisms at the bedside, plan and monitor treatment, and determine prognosis. In the neurointensive care unit, TCD is useful for detecting increased intracranial pressure and confirming cerebral circulatory arrest. TCD is of established value for screening children with sickle cell disease and detecting and monitoring vasospasm after spontaneous subarachnoid hemorrhage.

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Section: Detection Of Increased Icpmentioning

confidence: 98%

Advances in transcranial doppler ultrasonography

Tsivgoulis¹,

Alexandrov²,

Sloan

2008

Curr Neurol Neurosci Rep

157

127

View full text Add to dashboard Cite

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“…The relation between ICP and PI was estimated by the linear regression equation: ICP = 15.067 + 5.619 x PI, (the increase of (10,16,18,20). It has been demonstrated that waveforms obtained with TCD are affected by both increases of ICP or decreases of CPP.…”

Section: Gura M Et Al: Correlation Of Pulsatility Index With Intracrmentioning

confidence: 99%

Correlation of pulsatility index with intracranial pressure in traumatic brain injury

Güra¹,

Elmacı²,

Sarı³

et al. 2010

Turkish Neurosurgery

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AIm:In traumatic brain injury (TBI) patients, it is desired to monitor the intracranial pressure (ICP) to assess the cerebral haemodynamics and guide the therapy. The study was designed to see if the pulsatility index (PI) measured by transcranial Doppler ultrasonography (TCD) predicts information about ICP values. mAterIAl and methOds:In 52 TBI patients with Glasgow Coma Scale (GCS) score < 9, invasive intracranial monitoring and TCD ultrasonography for PI were performed through five days. ICP, cerebral perfusion pressure (CPP), PI values were recorded and calculated. The correlation and regression analysis between ICP, PI and CPP were investigated in the whole group and in patients with a Glasgow Outcome Score (GOS) of 3-5. results:The decline in ICP and PI values was significant through five days. The correlation between ICP and PI was strongly significant (p < 0.0001) on days 1, 3 and 5. In patients with a GOS of 3-5, correlation of ICP and PI was also observed. The only significant correlation observed between CPP and PI was on day 5. COnClusIOn:The strong correlation observed between ICP and PI through the management period of TBI patients can lead us to use TCD ultrasonography-derived PI as a guide if invasive monitoring is not available. BulGulAr: ICP ve PI değerlerindeki 5 gün boyunca olan azalma anlamlıdır. ICP ve PI arasındaki korelasyon 1, 3 ve 5. günlerde kuvvetli bir şekilde anlamlı bulunmuştur (p < 0,0001). Glasgow Outcome Skoru (GOS) 3-5 olan hastalarda da ICP ve PI değerlendirilmiştir. CPP ve PI arasındaki tek önemli korelasyon 5. günde tespit edilmiştir. sOnuÇ: ICP ve PI arasında bulunan güçlü korelasyon, tedavinin yönetilmesi için invaziv monitörizasyon yapmanın mümkün olmadığı hastalarda PI değerlerinin kullanılmasına yönlendirebilir.

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“…1,2,14 It has been shown that as ICP rises, typical changes in cerebral blood flow velocities can be measured by TCD. 9,15 Several studies have suggested that TCD-derived end diastolic flow velocity (Vd) and pulsatility index (PI) are useful as noninvasive estimates of ICP in adults with TBI. 7,8,16,19,20,29,30 There are very limited and opposing data on the utility of TCD-derived Vd and PI to noninvasively screen for intracranial hypertension and to follow ICP over time in children with TBI.…”

mentioning

confidence: 99%

Noninvasive screening for intracranial hypertension in children with acute, severe traumatic brain injury

O’Brien

Maa

Reuter‐Rice

2015

PED

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OBJECT The aim of this study was to determine the relationship between transcranial Doppler (TCD) derived pulsatility index (PI), end diastolic flow velocity (Vd), and intracranial pressure (ICP). The subjects in this study were 36 children admitted after severe traumatic brain injury (TBI) (postresuscitation Glasgow Coma Scale ≤ 8) undergoing invasive ICP monitoring. METHODS Subjects underwent a total of 148 TCD studies. TCD measurements of systolic flow velocity (Vs), Vd, and mean flow velocity (Vm) were performed on the middle cerebral artery (MCA) ipsilateral to the ICP monitor. The PI was calculated by the TCD software (Vs-Vd/Vm). ICP registrations were made in parallel with TCD measurements. RESULTS Using a PI threshold of 1.3, postinjury Day 0–1 PI had 100% sensitivity and 82% specificity at predicting an ICP ≥ 20 mm Hg (n = 8). During this time frame, a moderately strong relationship was observed between the MCA PI and actual ICP (r = 0.611, p = 0.01). When using a threshold of < 25 cm/sec, postinjury Day 0-1 Vd had a 56% sensitivity to predict an ICP ≥ 20 mm Hg. Beyond the initial 24 hours from injury, the sensitivity of an MCA PI of 1.3 to detect an ICP ≥20 mm Hg was 47%, and a weak relationship between actual ICP values and MCA PI (r = 0.376, p = 0.01) and MCA Vd (r = -0.284, p = 0.01) was found. CONCLUSIONS Postinjury Day 0-1 MCA PI > 1.3 has good sensitivity and specificity at predicting an ICP ≥ 20 mm Hg. In those children with TBI who initially do not meet clear criteria for invasive ICP monitoring but who are at risk for development of intracranial hypertension, TCD may be used as a noninvasive tool to screen for the development of elevated ICP in the first 24 hours following injury.

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Transcranial doppler recordings in raised intracranial pressure

Cited by 131 publications

References 18 publications

Advances in transcranial doppler ultrasonography

Advances in transcranial doppler ultrasonography

Correlation of pulsatility index with intracranial pressure in traumatic brain injury

Noninvasive screening for intracranial hypertension in children with acute, severe traumatic brain injury

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