Judgment of operative effect and prognosis of severe craniocerebral trauma by transcranial / 中华创伤杂志

ABSTRACT

Objective To observe the changes of cerebral vascular morphology and blood flow after craniocerebral trauma so as to investigate the role of transcranial Doppler sonography (TCD) combined with CT angiography (CTA) in judgment of the operative effect and prognosis of severe craniocerebral trauma.MethodsA total of 56 patients with craniocerebral trauma were monitored dynamically by using TCD before and after surgery.Dynamic CTA of head was also performed by using 128-slice spiral CT.Results TCD and CTA indicated that both the cerebral blood flow and vascular morphologychanged after craniocerebral trauma.CTA manifested mainly the vascular displacement or angiostegnosis and TCD showed mainly the high-resistance blood flow,indicating good operative effect.For the patients with vasospasm,the TCD manifested high-resistance flow (relatively good operative effect) or nail flow(mostly poor operative effect). The patients with vascular occlusion were associated with nail flow on TCD,with poor operative effect.ConclusionsTCD shows the velocity of cerebral blood flow and CTA shows the morphological change of cerebral vessels.Thereby,the combination of TCD and CTA can effectively judge the cerebral perfusion and provide a promising way for validating the operative effect and prognosis of craniocerebral trauma.