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Comparative Analysis of Simultaneous Transcranial Doppler and Perfusion Computed Tomography for Cerebral Perfusion
Alex Trofimov1, Artem Kopylov2, Michael Dobrzeniecki2
1Department of Neurosurgery, Privolzhsky Research Medical University, Nizhny Novgorod, Russia. xtro7@mail.ru.
Abstract:
The aim was to investigate the feasibility of simultaneous comparison of cerebral circulation in major vessels and microvasculature in patients suffering traumatic brain injury (TBI) with or without intracranial hematomas (IH).
Methods:
170 patients were divided into two groups: Group 1 - diffuse TBI (75 patients); and Group 2 - TBI with IH (95 patients: 18 epidural, 65 subdural and 12 multiple). Perfusion computed tomography (PCT) for assessment of volumetric cerebral blood flow (CBF) was done 2-15 days after admission to hospital. Simultaneous assessment of cerebral blood flow velocity (CBFV) in both middle cerebral arteries was done by transcranial Doppler.
Results:
In patients with diffuse TBI, CBF had statistically valid correlations with CBFV (r = 0.28, p = 0.0149 on the left side; r = 0.382, p = 0.00075 on the right side). In patients with TBI and IH, the analysis did not reveal any reliable correlations between the CBFV and CBF velocity in the temporal lobes, either on the side of the removed IH or on the opposite side.
Conclusion:
The greatest linear correlation was noted in patients with diffuse TBI without the development of a coarse shift of the midline structures and dislocation syndrome. This correlation decreases with the increase in injury severity and development of secondary complications in the acute period, which probably reflects impairment of the coupling of oxygen consumption by brain tissue and cerebral microcirculation.
