Incidence and effects of increased cerebral blood flow velocity after severe head injury: a transcranial Doppler ultrasound study I. Prediction of post-traumatic vasospasm and hyperemia

Yvonne A. Zurynski*, Nicholas W. C. Dorsch, Ian Pearson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Citations (Scopus)

Abstract

Cerebral blood flow velocity was monitored in 50 patients with severe head injury (GCS 8 or less) within 24 h of injury and at least once daily thereafter, using transcranial Doppler ultrasonography (TCD). Delayed post-traumatic vasospasm occurred in 20, and cerebral hyperemia in another 15. Doppler velocities were higher in vasospasm, which also lasted significantly longer than hyperemia. The presence of visible blood on an early CT scan was of some value in predicting vasospasm only (accuracy 59%). Xenon-133 cerebral blood flow (CBF) was also measured within 24 h of injury. An abnormal early cerebral blood flow level, either above or below a narrow central range, was more effective than CT in predicting vasospasm or hyperemia (accuracy 80%), while the combination of an abnormal blood flow and hemorrhagic findings on CT scan helped to determine which of these would occur later. Patients with an abnormal early cerebral blood flow and hemorrhagic findings on CT were more likely to develop vasospasm - accuracy for prediction of vasospasm 73%. This distinction may be of great importance, since these different groups of patients may well need different management.

Original languageEnglish
Pages (from-to)33-40
Number of pages8
JournalJournal of the Neurological Sciences
Volume134
Issue number1-2
DOIs
Publication statusPublished - 1 Jan 1995
Externally publishedYes

Keywords

  • Cerebral blood flow
  • Post-traumatic hyperemia
  • Post-traumatic vasospasm
  • Prediction of complications
  • Severe head injury
  • Transcranial Doppler

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