Related Experiment Video
Updated: Jun 18, 2026

A Preclinical Controlled Cortical Impact Model for Traumatic Hemorrhage Contusion and Neuroinflammation
Published on: June 10, 2020
Cerebral hemodynamic changes in severe head injury patients undergoing decompressive craniectomy
Amel Daboussi1, Vincent Minville, Sophie Leclerc-Foucras
1Service de Médecine Nucléaire, CHU Purpan, Hôpital Bicêtre, Le Kremlin Bicêtre, France.
Objective:
To assess the intracranial hemodynamic modifications induced by a decompressive craniectomy (DC) after severe traumatic brain injury (TBI), using transcranial Doppler (TCD) ultrasonography and intracranial pressure (ICP) sensor. Mortality rate and neurological outcomes were also evaluated after this procedure.
Design:
A prospective study was carried out on 26 TBI patients, measuring transcranial Doppler and ICP before, immediately after, and 48 hours after the DC, allowing for statistical analysis of hemodynamic changes. The mortality rate and the neurological outcomes were assessed.
Measurements And Results:
After DC, ICP decreased from 37+/-17 to 20+/-13 mm Hg (P=0.0003). The global cerebral blood flow was modified with diastolic velocities rising from 23+/-15 to 31+/-13 cm/s (P=0.0038) and a pulsatility index decreasing from 1.70+/-0.66 to 1.18+/-0.37 (P=0.0012). This normalization of the global cerebral hemodynamics after the DC was immediate, symmetric, and constant during the first 48 hours. Outcome was evaluated at 6 months: good recovery or moderate disability was observed in 11 patients (42%), persistent vegetative state in 7 patients (27%), and 8 patients died (31%).
Conclusions:
The DC results in a significant, immediate, and durable improvement of ICP associated with a normalization of cerebral blood flow velocities in most TBI patients with refractory intracranial hypertension.
Related Concept Videos
Increased Intracranial Pressure ll: Pathophysiology
Increased Intracranial Pressure l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Cerebral Edema ll: Pathophysiology

