scholarly journals 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

2017 ◽  
Vol 05 (04) ◽  
Author(s):  
Taysser Zaytoun ◽  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Doppler Ultrasound ◽  
Severe Traumatic Brain Injury ◽  
Transcranial Doppler ◽  
Transcranial Doppler Ultrasound ◽  
Coma Scale ◽  
Glascow Coma Scale

scholarly journals Noninvasive Evaluation of Intracranial Pressure by Transcranial Doppler Ultrasound in Patients With Traumatic Brain Injury

2020 ◽  
Author(s):  
Tao Chang ◽  
Yanlong Yang ◽  
Zhen Qian ◽  
Qingbao Guo ◽  
Lihong Li
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Intracranial Pressure ◽  
Intracranial Hypertension ◽  
Doppler Ultrasound ◽  
Transcranial Doppler ◽  
Strong Correlation ◽  
Transcranial Doppler Ultrasound ◽  
The Relationship ◽  
Different Levels

Abstract Background As a noninvasive monitoring measure, transcranial Doppler ultrasound (TCD) has been widely used to monitor the secondary brain injury in patients with traumatic brain injury (TBI). There are different physiological theories on the noninvasive assessment of intracranial pressure by TCD parameters, including ONSD and PI, which may cause that the change of ONSD and PI is not always synchronous with that of ICP. Therefore, the objective of this study was to investigate the relationship between PI or ONSD and ICP at different levels or in different periods after the operation, and the ability of prediction intracranial hypertension with these parameters in patients with TBI. Methods The clinical data of 68 patients with TBI were retrospectively analyzed. The statistical correlation analysis was performed to investigate the relationship between the PI or ONSD and ICP one week after the operation. Besides, the area under the curve (AUC) of ONSD or PI alone or a combination of them was calculated to determine the ability of intracranial hypertension. Results 1. There was a correlation between ONSD and ICP ≥ 20 mmHg (r = 0.665, p < 0.001), ICP < 20 mmHg (r = 0.358, p = 0.006). The correlation still remained at ONSD ≥ 5 mm (r = 0.644, p < 0.001), but no correlation at ONSD < 5 mm (p = 0.137). 2. There was a strong correlation between PI and ICP at ICP of 15–20 mmHg (r = 0.705, p < 0.001), and ICP ≥ 20 mmHg (r = 0.716, p < 0.001). Nevertheless, it revealed a weak correlation at PI < 1.2 (r = 0.271, p = 0.021), PI ≥ 1.2 (r = 0.350, p = 0.020). In different period after the operation, there was a moderate correlation between ICP and PI on days 3, 4, and 5 (r = 0.508, p < 0.001), a strong correlation on days 6 and 7 after the operation (r = 0.645, p < 0.001). 3. For prediction intracranial hypertension with PI ≥ 1.2 or ONSD ≥ 5 mm alone or a combination of ONSD ≥ 5 mm and PI ≥ 1.2, the AUC value was 0.729 (p < 0.001), 0.900 (p < 0.001), and 0.943 (p < 0.001), respectively. Conclusion The correlation between the parameters of TCD, including ONSD and PI, and invasive ICP vary at different levels of ICP and in different periods in patients with TBI post-operation. It could also allow for a more accurate prediction of elevated intracranial pressure with a combination of ONSD ≥ 5 mm and PI ≥ 1.2.

scholarly journals Modulated Neuroprotection in Unresponsive Wakefulness Syndrome after Severe Traumatic Brain Injury

2021 ◽  
Vol 11 (8) ◽  
pp. 1044
Author(s):  
Cristina Daia ◽  
Cristian Scheau ◽  
Aura Spinu ◽  
Ioana Andone ◽  
Cristina Popescu ◽  
...  
Keyword(s):  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Glasgow Coma Scale ◽  
Severe Traumatic Brain Injury ◽  
Functional Independence ◽  
Unresponsive Wakefulness Syndrome ◽  
Coma Scale ◽  
Severe Tbi ◽  
Neuroprotective Treatment ◽  
Gcs Score

Background: We aimed to assess the effects of modulated neuroprotection with intermittent administration in patients with unresponsive wakefulness syndrome (UWS) after severe traumatic brain injury (TBI). Methods: Retrospective analysis of 60 patients divided into two groups, with and without neuroprotective treatment with Actovegin, Cerebrolysin, pyritinol, L-phosphothreonine, L-glutamine, hydroxocobalamin, alpha-lipoic acid, carotene, DL-α-tocopherol, ascorbic acid, thiamine, pyridoxine, cyanocobalamin, Q 10 coenzyme, and L-carnitine alongside standard treatment. Main outcome measures: Glasgow Coma Scale (GCS) after TBI, Extended Glasgow Coma Scale (GOS E), Disability Rankin Scale (DRS), Functional Independence Measurement (FIM), and Montreal Cognitive Assessment (MOCA), all assessed at 1, 3, 6, 12, and 24 months after TBI. Results: Patients receiving neuroprotective treatment recovered more rapidly from UWS than controls (p = 0.007) passing through a state of minimal consciousness and gradually progressing until the final evaluation (p = 0.000), towards a high cognitive level MOCA = 22 ± 6 points, upper moderate disability GOS-E = 6 ± 1, DRS = 6 ± 4, and an assisted gait, FIM =101 ± 25. The improvement in cognitive and physical functioning was strongly correlated with lower UWS duration (−0.8532) and higher GCS score (0.9803). Conclusion: Modulated long-term neuroprotection may be the therapeutic key for patients to overcome UWS after severe TBI.

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