Role of Transcranial Doppler Ultrasound as a Predictor of Outcome in Severe Traumatic Brain Injury and Its Correlation with Glascow Coma Scale and Full Outline of Unresponsiveness Score
Journal Title: Journal of Medical Science And clinical Research - Year 2017, Vol 5, Issue 4
Abstract
Introduction: Traumatic brain injury(TBI) is a major public health problem. It is considered to be one of the leading causes of death and disability worldwide. After TBI cerebral blood flow (CBF) becomes extremely low approaching ischemic thresholds. Concurrently, cerebral blood flow velocities become strongly correlated to CBF itself post injury. Identification of such hemodynamic disturbances can be used to predict outcome in severe TBI when measured immediately post-injury using Transcranial Doppler (TCD). TCDpermits non invasive assessment of different CBF velocities as well as pulsatility index (PI). Abnormal measurement of such indices is believed to correlate to poor outcome. Methods: 120 patients with severe TBI, according to GCS, underwent TCD within 24 hours post trauma. Middle cerebral artery (MCA) velocities and pulsatility index, as well as other clinical and neuro imaging data, were recorded and accordingly patients were divided into 3 groups: patients with normal TCD measurements, patients with hypoperfusion and patients with vasospasm. Hypoperfusion was defined by meeting two out of three criteria: mean flow velocity (MFV) of MCA< 35cm/sec, End diastolic velocity (EDV) of MCA<20cm/sec, PI>1.4. Vasospasm was defined as MFV>120 cm/sec. Outcome was evaluated using the Glasgow Outcome Scale extended(GOSE) at 3 months, as well as in-hospital mortality.TCD measurements were also correlated to GCS and FOUR score. Result: There was a significant correlation between PI and GOSE at 3 months. There was also significant correlation between PI and mortality. However, different MCA velocities did not show any correlation with GOSE or mortality. Strong negative correlation was recognized between PI and GCS and FOUR scores. Conclusion: Pulsatility index, when measured within the first 24 hours post-trauma, is considered a good predictor of mortality as well as functional outcome at 3months. Abnormal pulsatility index values correlate with the severity of injury (in terms of GCS and FOUR scores).
Authors and Affiliations
Taysser Zaytoun
Keywords
Related Articles
- EP ID EP284373
- DOI -
- Views 73
- Downloads 0
Magnitude and characteristics of Road Traffic Accidents in Kashmir Valley
An alarming increase in morbidity and mortality owing to road traffic accidents over the past few decades is becoming a routine and matter of great concern globally. Road traffic crashes account for one fourth of the tot...
Intracranial Haemorrhage: A Rare Manifestation of Scrub Typhus
Two Patients diagnosed with scrub typhus through serology, presented with intracranial haemorrhage in acute phase. Orientia tsutsugamushi should be considered as a common factor for cerebrovascular accidents in the regio...
Assessment of Blood Iron and Manganese on Artesant Welders Exposed to Welding Fumes
Whole blood iron and manganese levels in artesant welders control subjects were invstigated. Five (5ml) blood samples were collected via venepuncture from thirty (35) welders and twenty five (25) control subjects after t...
Comparison between Mulligan Traction Leg Raise versus Slumps Stretching on Pain, Passive Leg Raise, and Functional Disability in Lumbar Radiculopathy
Lumbar spine disorders rank 5th among the diseases categories with 37% of cost a direct case of physical therapy services. So the intervention requires a beneficial, safer, and cost effective treatment. Conservative trea...
Awareness about Mosquito Borne Diseases and Practice about Preventive Methods Against Mosquito Bite in Rural Field Practice Area of a Tertiary Care Teaching Institute, Telangana State
Background: Mosquitoes can transmit various diseases like Malaria, Filaria, Japanese Encephalitis, Dengue and Chikungunya. Awareness about the risk of mosquito bite and source reduction can prevent the transmission of th...