ArticleBioMed research international2013
Posttraumatic refractory intracranial hypertension and brain herniation syndrome: cerebral hemodynamic assessment before decompressive craniectomy.
Article in BioMed research international, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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8 citing papers in PubMed, 23 citations in OpenAlex.
- Extubation timing and risk of extubation failure in aneurysmal subarachnoid hemorrhage patients.Chinese neurosurgical journal · 2024Article
- Assessing ultrasonographic optic nerve sheath diameter in animal model with anesthesia regimens.Acta cirurgica brasileira · 2022Article
- Decompressive Craniectomy for Traumatic Brain Injury: Postoperative TCD Cerebral Hemodynamic Evaluation.Frontiers in neurology · 2019Article
- Predictable Values of Decompressive Craniectomy in Patients with Acute Subdural Hematoma: Comparison between Decompressive Craniectomy after Craniotomy Group and Craniotomy Only Group.Korean journal of neurotrauma · 2018Article
- Cardiac troponin and cerebral herniation in acute intracerebral hemorrhage.Brain and behavior · 2017Article
- Central hyperventilation syndrome due to massive pneumocephalus after endoscopic third ventriculostomy: a case report.Korean journal of anesthesiology · 2016Article
- Head computed tomographic measurement as a predictor of outcome in patients with subdural hematoma with cerebral edema.Scandinavian journal of trauma, resuscitation and emergency medicine · 2016Article
- The effect of craniectomy size on mortality, outcome, and complications after decompressive craniectomy at a rural trauma center.Journal of neurosciences in rural practice · 2014Article
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Authors and funding
7 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe pathophysiology of traumatic brain swelling remains little understood. An improved understanding of intracranial circulatory process related to brain herniation may have treatment implications.
objectiveTo investigate the cerebral hemodynamic changes associated with brain herniation syndrome due to traumatic brain swelling.
methodsNineteen 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.
resultsA 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.
conclusionsThere is a marked heterogeneity of cerebral hemodynamic disturbances among patients with brain herniation syndrome.
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