Transcranial Doppler ultrasonography as an early outcome forecaster following severe brain injury

Splavski, Bruno; Radanović, Branko; D, Vranković; Has, Borislav; Mužević, Dario; Jančuljak, Davor; Legčević, Jelena

doi:10.1080/02688690601048104

Cited by 16 publications

(5 citation statements)

References 27 publications

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“…TCD flow velocity measurements follow the same trend as pre-clinical studies discussed above, most indicating an increase in PI with pathology [130-141], and good correlation with clinical condition [139,142]. Using a technique similar to that of Eide described above, Splavski et al showed good correlation between the degree of elevated PI and the duration of time (in hours per day) for which the mean ICP was elevated (ICP > 25 mmHg) [138].…”

Section: The Intracranial Pulse Wave - Clinical Studiesmentioning

confidence: 69%

The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility

Wagshul

Eide

Madsen

2011

Fluids Barriers CNS

386

311

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The maintenance of adequate blood flow to the brain is critical for normal brain function; cerebral blood flow, its regulation and the effect of alteration in this flow with disease have been studied extensively and are very well understood. This flow is not steady, however; the systolic increase in blood pressure over the cardiac cycle causes regular variations in blood flow into and throughout the brain that are synchronous with the heart beat. Because the brain is contained within the fixed skull, these pulsations in flow and pressure are in turn transferred into brain tissue and all of the fluids contained therein including cerebrospinal fluid. While intracranial pulsatility has not been a primary focus of the clinical community, considerable data have accrued over the last sixty years and new applications are emerging to this day. Investigators have found it a useful marker in certain diseases, particularly in hydrocephalus and traumatic brain injury where large changes in intracranial pressure and in the biomechanical properties of the brain can lead to significant changes in pressure and flow pulsatility. In this work, we review the history of intracranial pulsatility beginning with its discovery and early characterization, consider the specific technologies such as transcranial Doppler and phase contrast MRI used to assess various aspects of brain pulsations, and examine the experimental and clinical studies which have used pulsatility to better understand brain function in health and with disease.

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Section: The Intracranial Pulse Wave - Clinical Studiesmentioning

confidence: 69%

The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility

Wagshul

Eide

Madsen

2011

Fluids Barriers CNS

386

311

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“…In the observational study of Splavski et al also, have concluded that measuring the MCA blood velocity after TBI is a worthy tool to estimate ICP, as well as to evaluate early post-traumatic cerebral haemodynamics (24).…”

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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“…Further research is needed to establish the gold standard and validate findings in children [ 20 ]. By calculating linear regression equations, Splavski, 2006, demonstrated that each additional unit of PI value will be reduced by 2.613 units in the Glasgow Outcome Score (GOS) 6 months later [ 21 ]. PI and GOS showed similar trends at 3 and 12 months after TBI in our cohort study.…”

Section: Discussionmentioning

confidence: 99%

Cerebral Pulsatility Index and In-Hospital Mortality in Chinese Patients with Traumatic Brain Injury: A Retrospective Cohort Study

Mei

Zhou

Chen

et al. 2022

JCM

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There are limited studies on the relationship between the vascular transcranial Doppler (TCD) pulsatility index (PI) and in-hospital mortality in patients with traumatic brain injury (TBI). To address this issue, we conducted this study to explore whether, in newly diagnosed Chinese TBI patients, the PI is an independent predictor of the in-hospital mortality rate after adjusting for other covariates. This study is a retrospective cohort study. From 24 March 2019 to 24 January 2020, we recruited 144 Chinese patients with newly diagnosed TBI from a Chinese hospital. The independent variable was the PI, and the dependent variable was in-hospital mortality in TBI patients. The relationship between the PI and in-hospital mortality in TBI patients was nonlinear and had an inflection point of 1.11. In the multivariate analysis, after adjusting for potential confounders, the effect sizes and confidence intervals per additional 0.1 units on the left and right sides of the inflection point were 4.09 (1.30–12.83) and 1.42 (0.93–2.17). The relationship between the PI and in-hospital mortality was nonlinear. The PI was positively related with in-hospital mortality when the PI was less than 1.11.

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Transcranial Doppler ultrasonography as an early outcome forecaster following severe brain injury

Cited by 16 publications

References 27 publications

The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility

The pulsating brain: A review of experimental and clinical studies of intracranial pulsatility

Correlation of pulsatility index with intracranial pressure in traumatic brain injury

Cerebral Pulsatility Index and In-Hospital Mortality in Chinese Patients with Traumatic Brain Injury: A Retrospective Cohort Study

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