Study of clinical value of noninvasive intracranial pressure monitoring with TCD in patients with traumatic brain injury / 重庆医科大学学报

ABSTRACT

Objective: This study was designed to analyze the results from ICP and TCD monitoring in patients with traumatic brain injury (TBI) in order to further evaluate the clinical significance of noninvasive ICP monitoring with TCD. Methods:The monitoring and measurements with TCD were performed beside beds on the following day of surgery to record the spectral atlas and parameter of the middle cerebral artery (MCA) of suffering side in 32 patients with TBI. The values of ICP were recorded at the same time. The patients were divided into four groups according to ICP. The comparative analyses of results of TCD and ICP monitoring were carried out.Results:(1)Spectral atlas The spectral atlas of Mild ICP Increase Group showed no visible differences from those of Normal ICP Group.A phenomenon of deepened notch before reaching D peak was found in some cases of Moderate ICP Increase Group while occurrence of single cusp peak and disappearance of S2 peak with decreased diastolic velocity were observed in Severe ICP Increase Group. (2) Parameter of TCD With the increase of ICP,Vs,Vd and Vm were decreased accordingly with the most significant dropping in Vd while PI and RI were elevated gradually. Conclusion:This study suggests that TCD can be applied to monitor noninvasively ICP and indicate the significant increase of ICP in patients with TBI,but fail to detect mild increase of ICP. Spectral atlas is superior to parameters of TCD in judgment of increased ICP