Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

Bor-Seng-Shu, Edson; Teixeira, Manoel Jacobsen; Hirsch, Roberto; Andrade, Almir Ferreira de; Marino, Raul

doi:10.1590/s0004-282x2004000400028

Cited by 20 publications

(10 citation statements)

References 36 publications

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“…In critical IH, the intracranial waveform degrades to become a small systolic spike and then disappears altogether [44] . The relationship between TCDhemodynamic patterns and the different states of ICP reinforces the idea that TCD can be useful for determining the optimal range of arterial blood pressure for adequate cerebral blood flow dynamics in FHF patients [45,46] . Cerebral autoregulation (CA) is impaired in patients with FHF, and CBF has been described as correlating with ICP in FHF [23] .…”

Section: Cerebral Blood Flow Monitoringsupporting

confidence: 60%

Multimodal brain monitoring in fulminant hepatic failure

Paschoal¹,

Nogueira²,

Ronconi³

et al. 2016

WJH

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Acute liver failure, also known as fulminant hepatic failure (FHF), embraces a spectrum of clinical entities characterized by acute liver injury, severe hepatocellular dysfunction, and hepatic encephalopathy. Cerebral edema and intracranial hypertension are common causes of mortality in patients with FHF. The management of patients who present acute liver failure starts with determining the cause and an initial evaluation of prognosis. Regardless of whether or not patients are listed for liver transplantation, they should still be monitored for recovery, death, or transplantation. In the past, neuromonitoring was restricted to serial clinical neurologic examination and, in some cases, intracranial pressure monitoring. Over the years, this monitoring has proven insufficient, as brain abnormalities were detected at late and irreversible stages. The need for real-time monitoring of brain functions to favor prompt treatment and avert irreversible brain injuries led to the concepts of multimodal monitoring and neurophysiological decision support. New monitoring techniques, such as brain tissue oxygen tension, continuous electroencephalogram, transcranial Doppler, and cerebral microdialysis, have been developed. These techniques enable early diagnosis of brain hemodynamic, electrical, and biochemical changes, allow brain anatomical and physiological monitoring-guided therapy, and have improved patient survival rates. The purpose of this review is to discuss the multimodality methods available for monitoring patients with FHF in the neurocritical care setting.

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Section: Cerebral Blood Flow Monitoringsupporting

confidence: 60%

Multimodal brain monitoring in fulminant hepatic failure

Paschoal¹,

Nogueira²,

Ronconi³

et al. 2016

WJH

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“…Alguns trabalhos 1,[3][4][5][6][7] foram publicados na literatura médica ocidental descrevendo estes valores para os diferentes parâmetros de fluxo sanguí-neo. No Brasil, pesquisas [8][9][10][11] foram realizadas com relação à aplicação do DTC em diferentes situações clínicas, porém para valores de normalidade são desconhecidos. Fatores como hematócrito, idade, sexo e pressão arterial parcial de CO2 (PaCO2) podem influenciar nos valores das medidas realizadas em diferentes populações.…”

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Doppler transcraniano convencional em voluntários assintomáticos: variabilidade e valores de referência para parâmetros de fluxo sanguíneo

Barbosa

Abdala

Carrete

et al. 2006

Arq. Neuro-Psiquiatr.

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RESUMO - Reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial DopplerABSTRACT -Objective: To establish reference values for measures of blood flow velocities and impedance indexes in healthy individuals through conventional transcranial Doppler (TCD) and to observe their variations in relation to the age and sex. Method: 88 asymptomatic volunteers were examined without antecedents of cardiac, peripheral or cerebrovascular diseases. The TCD were accomplished by the same examiner. The middle, anterior and posterior cerebral arteries were studied through the temporal acoustic window and the vertebral and basilar arteries through the suboccipital acoustic window. The values of mean velocity (MV), peak-systolic velocity (PSV), final diastolic velocity (FDV), resistance index (RI) and pulsatility index (PI) of each examined arterial segment were filed. Results: The reference limits found by us were similar to the described by other authors for all of the studied parameters. There was tendency of the flow velocities decrease and of the impedance indexes increase with moving forward of the age. The values of velocities in the women were superior to the found in men. Conclusion: TCD was shown useful in the evaluation of hemodynamic cerebral for our population. Our results are similar to the other studies, so much in the reference values as in relationship with the age and the sex.

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“…27,28 These devices generate ultrasound beams that differ greatly in acoustic properties, such as frequency, mechanical index, and the amount of brain tissue included in the beam (that is, areas of the brain exposed to ultrasound energy). Transcranial Doppler ultrasonography equipped with a 2-MHz transducer has been widely used for evaluating patients with acute ischemic stroke, 27,28 traumatic brain injury, 9,10 and aneurysmal subarachnoid hemorrhage. 7 This nonimaging and hand-held ultrasound examination device provides real-time blood flow velocity from cerebral arteries that can indicate arterial occlusion or recanalization, embolization, functional status of collateral circulatory pathways, and blood steal phenomenon.…”

Section: Discussionmentioning

confidence: 99%

Sonothrombolysis for acute ischemic stroke: a systematic review of randomized controlled trials

Bor-Seng-Shu

Nogueira

Figueiredo

et al. 2012

FOC

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Object Sonothrombolysis has recently been considered an emerging modality for the treatment of stroke. The purpose of the present paper was to review randomized clinical studies concerning the effects of sonothrombolysis associated with tissue plasminogen activator (tPA) on acute ischemic stroke. Methods Systematic searches for literature published between January 1996 and July 2011 were performed for studies regarding sonothrombolysis combined with tPA for acute ischemic stroke. Only randomized controlled trials were included. Data extraction was based on ultrasound variables, patient characteristics, and outcome variables (rate of intracranial hemorrhages and arterial recanalization). Results Four trials were included in this study; 2 trials evaluated the effect of transcranial Doppler (TCD) ultrasonography on sonothrombolysis, and 2 addressed transcranial color-coded duplex (TCCD) ultrasonography. The frequency of ultrasound waves varied from 1.8 to 2 MHz. The duration of thrombus exposure to ultrasound energy ranged from 60 to 120 minutes. Sample sizes were small, recanalization was evaluated at different time points (60 and 120 minutes), and inclusion criteria were heterogeneous. Sonothrombolysis combined with tPA did not lead to an increase in symptomatic intracranial hemorrhagic complications. Two studies demonstrated that patients treated with ultrasound combined with tPA had statistically significant higher rates of recanalization than patients treated with tPA alone. Conclusions Despite the heterogeneity and the limitations of the reviewed studies, there is evidence that sonothrombolysis associated with tPA is a safe procedure and results in an increased rate of recanalization in the setting of acute ischemic stroke when wave frequencies and energy intensities of diagnostic ultrasound systems are used.

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Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

Cited by 20 publications

References 36 publications

Multimodal brain monitoring in fulminant hepatic failure

Multimodal brain monitoring in fulminant hepatic failure

Doppler transcraniano convencional em voluntários assintomáticos: variabilidade e valores de referência para parâmetros de fluxo sanguíneo

Sonothrombolysis for acute ischemic stroke: a systematic review of randomized controlled trials

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