Monitoring of Regional Cerebral Blood Flow (CBF) in Acute Head Injury by Thermal Diffusion

1993 ◽  
pp. 47-49 ◽  
Author(s):  
M. L. Schröder ◽  
J. P. Muizelaar
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Head Injury ◽  
Thermal Diffusion ◽  
Regional Cerebral Blood Flow ◽  
Regional Cerebral Blood ◽  
Acute Head Injury

scholarly journals Relations of blood pressure and head injury to regional cerebral blood flow

2016 ◽  
Vol 365 ◽  
pp. 9-14 ◽  
Author(s):  
Jason E. Kisser ◽  
Allyssa J. Allen ◽  
Leslie I. Katzel ◽  
Carrington R. Wendell ◽  
Eliot L. Siegel ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Head Injury ◽  
Regional Cerebral Blood Flow ◽  
Regional Cerebral Blood

scholarly journals Study of Regional Cerebral Blood Flow in Experimental Head Injury: Changes Following Cerebral Contusion and During Spreading Depression

1991 ◽  
Vol 31 (11) ◽  
pp. 685-690 ◽  
Author(s):  
Yoshinori OZAWA ◽  
Takao NAKAMURA ◽  
Kenro SUNAMI ◽  
Motoo KUBOTA ◽  
Chiaki ITO ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Head Injury ◽  
Regional Cerebral Blood Flow ◽  
Spreading Depression ◽  
Regional Cerebral Blood ◽  
Cerebral Contusion

Continuous monitoring of regional cerebral blood flow: experimental and clinical validation of a novel thermal diffusion microprobe

2000 ◽  
Vol 93 (2) ◽  
pp. 265-274 ◽  
Author(s):  
Peter Vajkoczy ◽  
Harry Roth ◽  
Peter Horn ◽  
Thomas Lucke ◽  
Claudius Thomé ◽  
...  
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Thermal Diffusion ◽  
Regional Cerebral Blood Flow ◽  
Linear Regression Analysis ◽  
Secondary Brain Injury ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Arterial Blood ◽  
Fine Print

Object. Current clinical neuromonitoring techniques lack adequate surveillance of cerebral perfusion. In this article, a novel thermal diffusion (TD) microprobe is evaluated for the continuous and quantitative assessment of intraparenchymal regional cerebral blood flow (rCBF).Methods. To characterize the temporal resolution of this new technique, rCBF measured using the TD microprobe (TD-rCBF) was compared with rCBF levels measured by laser Doppler (LD) flowmetry during standardized variations of CBF in a sheep model. For validation of absolute values, the microprobe was implanted subcortically (20 mm below the level of dura) into 16 brain-injured patients, and TD-rCBF was compared with simultaneous rCBF measurements obtained using stable xenon-enhanced computerized tomography scanning (sXe-rCBF). The two techniques were compared using linear regression analysis as well as the Bland and Altman method.Stable TD-rCBF measurements could be obtained throughout all 3- to 5-hour sheep experiments. During hypercapnia, TD-rCBF increased from 49.3 ± 15.8 ml/100 g/min (mean ± standard deviation) to 119.6 ± 47.3 ml/100 g/min, whereas hypocapnia produced a decline in TD-rCBF from 51.2 ± 12.8 ml/100 g/min to 39.3 ± 5.6 ml/100 g/min. Variations in mean arterial blood pressure revealed an intact autoregulation with pressure limits of approximately 65 mm Hg and approximately 170 mm Hg. After cardiac arrest TD-rCBF declined rapidly to 0 ml/100 g/min. The dynamics of changes in TD-rCBF corresponded well to the dynamics of the LD readings. A comparison of TD-rCBF and sXe-rCBF revealed a good correlation (r = 0.89; p <0.0001) and a mean difference of 1.1 ± 5.2 ml/100 g/min between the two techniques.Conclusions. The novel TD microprobe provides a sensitive, continuous, and real-time assessment of intraparenchymal rCBF in absolute flow values that are in good agreement with sXe-rCBF measurements. This study provides the basis for the integration of TD-rCBF into multimodal monitoring of patients who are at risk for secondary brain injury.

Regional cerebral blood flow monitoring in the diagnosis of delayed ischemia following aneurysmal subarachnoid hemorrhage

2003 ◽  
Vol 98 (6) ◽  
pp. 1227-1234 ◽  
Author(s):  
Peter Vajkoczy ◽  
Peter Horn ◽  
Claudius Thome ◽  
Elke Munch ◽  
Peter Schmiedek
Keyword(s):  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Subarachnoid Hemorrhage ◽  
Thermal Diffusion ◽  
Regional Cerebral Blood Flow ◽  
High Grade ◽  
Regional Cerebral Blood ◽  
Content Type ◽  
Symptomatic Vasospasm ◽  
Fine Print

Object. The goal of this study was to evaluate regional cerebral blood flow (rCBF) monitoring, performed using thermal-diffusion (TD) flowmetry, as a novel means for the bedside diagnosis of symptomatic vasospasm. Methods. Fourteen patients with high-grade subarachnoid hemorrhage (SAH) who underwent early clip placement for anterior circulation aneurysms were prospectively entered into the study. Thermal-diffusion microprobes were implanted into the white matter of vascular territories that were deemed at risk for developing symptomatic vasospasm. Data on arterial blood pressure, intracranial pressure, cerebral perfusion pressure, rCBF measurement obtained using a TD probe (TD-rCBF), cerebrovascular resistance (CVR), and blood flow velocities were collected at the patient's bedside. The diagnosis of symptomatic vasospasm was based on the manifestation of a delayed ischemic neurological deficit and/or a reduced territorial level of CBF as assessed using stable Xe-enhanced computerized tomography (CT) scanning in combination with vasospasm demonstrated by angiography. Bedside monitoring of TD-rCBF and CVR allowed the detection of symptomatic vasospasm. In the 10 patients with vasospasm the TD-rCBF decreased from 21 ± 4 to 9 ± 1 ml/100 g/min (mean ± standard error of the mean), whereas in the four other patients the TD-rCBF value remained unchanged (mean TD-rCBF = 25 ± 4 compared with 21 ± 4 ml/100 g/min). A comparison of the results of TD-rCBF and Xe-enhanced CT studies, as well as the calculation of sensitivities, specificities, predictive values, and likelihood ratios, identified a TD-rCBF value of 15 ml/100 g/min as a reliable cutoff for the diagnosis of symptomatic vasospasm. In addition, TD flowmetry was characterized by a more favorable diagnostic reliability than transcranial Doppler ultrasonography. Conclusions. Thermal-diffusion flowmetry represents a promising method for the bedside monitoring of patients with SAH to detect symptomatic vasospasm. This is of major clinical interest for patients with high-grade SAH, who often cannot be assessed neurologically.

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