Related Experiment Video

Updated: May 22, 2026

Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery
04:01

Point of Care Transcranial Color-Coded Duplex Ultrasound of the Middle Cerebral Artery

Published on: August 9, 2024

Cerebral blood flow velocity changes and the value of the pulsatility index post decompressive craniectomy

Christos Lazaridis1, Stacia M DeSantis, Alex W Vandergrift

  • 1Neurosciences Intensive Care Unit, Medical University of South Carolina, Charleston, SC 29425, USA. lazaridi@musc.edu

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|May 5, 2012
PubMed

Insights

Decompressive craniectomy (DC) can relieve brain pressure, but its effects on cerebral blood flow are unclear. Transcranial Doppler monitoring of cerebral blood flow velocities and pulsatility indices may help assess DC effectiveness.

Area of Science:

  • Neurosurgery
  • Neurology
  • Critical Care Medicine

Background:

  • Decompressive craniectomy (DC) is a critical neurosurgical procedure to manage intractable intracranial hypertension and prevent cerebral herniation.
  • Controversy persists regarding optimal patient selection, procedural timing, and neurological outcomes following DC.
  • Recent research has begun exploring the cerebral hemodynamic consequences after decompressive craniectomy.

Observation:

  • This report details two patients undergoing DC: one unilateral and one suboccipital decompression (SOC).
  • Cerebral blood flow velocities (FV) and pulsatility indices (PI) were monitored using transcranial Doppler (TCD).
  • This marks the first reported use of FV/PI monitoring following a suboccipital decompression.

Findings:

  • Transcranial Doppler (TCD) offers a non-invasive and accessible method for monitoring cerebral hemodynamics post-DC.
  • Pulsatility index (PI) changes may offer valuable insights into the timing and efficacy of decompressive procedures.
  • Cerebral blood flow velocity (FV) and pulsatility index (PI) monitoring can provide objective data on hemodynamic changes after craniectomy.

Implications:

  • Cerebral hemodynamic monitoring via TCD may refine the management and assessment of decompressive craniectomy.
  • Understanding hemodynamic changes post-DC can potentially improve patient outcomes and guide clinical decision-making.
  • Further research into TCD monitoring after various types of decompressive procedures is warranted.

More Related Videos

Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound10:41

Analysis of Cerebral Vasospasm in a Murine Model of Subarachnoid Hemorrhage with High Frequency Transcranial Duplex Ultrasound

Published on: June 3, 2021

Related Concept Videos

Increased Intracranial Pressure ll: Pathophysiology01:29

Increased Intracranial Pressure ll: Pathophysiology

Increased intracranial pressure (ICP) refers to a potentially life-threatening rise in pressure inside the skull. This usually happens when there is a major change in the volume of brain tissue, blood, or cerebrospinal fluid (CSF) — the three components inside the skull. According to the Monro-Kellie doctrine, if the volume of one component increases, the volumes of the other components must decrease to maintain normal pressure. If this does not happen, ICP rises.The process often begins with...
Increased Intracranial Pressure l: Introduction01:14

Increased Intracranial Pressure l: Introduction

Intracranial hypertension is a sustained elevation of intracranial pressure (ICP) above 22 mm Hg. In supine adults, normal ICP is ~7–15 mm Hg.The rigid, nonexpandable cranium contains three components—brain tissue, blood, and cerebrospinal fluid (CSF)—that total ~1,700 mL in a typical adult: 1,400 mL brain (~80%), 150 mL blood (~10%), and 150 mL CSF (~10%). According to the Monro–Kellie doctrine, total intracranial volume is effectively fixed. When one component expands, CSF and venous blood...
Cerebral Edema ll: Pathophysiology01:22

Cerebral Edema ll: Pathophysiology

Vasogenic edema is a major form of cerebral edema characterized by abnormal accumulation of fluid in the brain’s extracellular space due to disruption of the blood–brain barrier (BBB). The BBB is a specialized structure composed of endothelial cells connected by tight junctions, supported by astrocytic endfeet and a basement membrane. Under normal conditions, it tightly regulates the movement of ions, proteins, and solutes between the bloodstream and brain parenchyma. When this barrier loses...