Abstract
Aim: The purpose of this study was to study changes in cerebral microcirculation parameters in the development of secondary cerebral ischemia (SCI).
Methods: A total of 202 patients with a Glasgow Coma Scale score ≤ 12 after experiencing a traumatic brain injury (TBI) were recruited for the study within 6 h of the injury. All patients were subjected to perfusion computed tomography. The cerebral blood flow velocity was recorded using transcranial Doppler ultrasound. The arterial blood pressure was measured noninvasively. The cerebrovascular resistance (CVR), cerebral arterial compliance (CAC), cerebrovascular time constant (CTC), and critical closing pressure (CCP) were measured using the neuromonitoring complex. All patients had unilateral foci of posttraumatic ischemia. Statistical analysis was performed using a paired Student’s t test and factor analysis.
Results and Conclusion: The CVR and CCP were significantly increased in patients who developed SCI after TBI, whereas the CAC and CTC were significantly decreased (P < 0.05). Factor analyses revealed that the CVR, CAC, and CTC were significantly associated with development of posttraumatic ischemia (P < 0.05). The changes in the CVR and CCP in patients with TBI were significantly associated with SCI development (P < 0.05).
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References
Walder B, Haller G, Rebetez M (2013) Severe traumatic brain injury in a high-income country: an epidemiological study. J Neurotrauma 30:1934–1942
Spaite D, Hu C, Bobrow B, Chikani V (2017) Association of out-of-hospital hypotension depth and duration with traumatic brain injury mortality. Ann Emerg Med 70:522–530
Miles K, Eastwood JD, Konig M (eds) (2007) Multidetector computed tomography in cerebrovascular disease: CT perfusion imaging. Informa, Abingdon
Donahue J, Wintermark M (2015) Perfusion CT and acute stroke imaging: foundations, applications, and literature review. J Neuroradiol 42(1):21–29
Sheludyakov A, Martynov D, Yuryev M (2020) The сerebrovascular time constant in patients with head injury and posttraumatic cerebral vasospasm. Acta Neurochir Suppl 127:191–194
Trofimov A, Kalentyev G, Voennov O (2018) The cerebrovascular resistance in combined traumatic brain injury with intracranial hematomas. Acta Neurochir Suppl 126:25–28
Rhodes JK, Chandrasekaran S, Andrews PJ (2016) Early changes in brain oxygen tension may predict outcome following severe traumatic brain injury. Acta Neurochir Suppl 122:9–16. https://doi.org/10.1007/978-3-319-22533-3_2
Marmarou A (2007) A review of progress in understanding the pathophysiology and treatment of brain edema. Neurosurg Focus 22(5):E1
Rey FE (2002) Perivascular superoxide anion contributes to impairment of endothelium-dependent relaxation: role of gp91(phox). Circulation 106(19):2497–2502
Ehlert A, Schmidt C, Wölfer J (2016) Molsidomine for the prevention of vasospasm-related delayed ischemic neurological deficits and delayed brain infarction and the improvement of clinical outcome after subarachnoid hemorrhage: a single-center clinical observational study. J Neurosurg 124(1):51–58. https://doi.org/10.3171/2014.12.JNS13846
Bullock R (1991) Glial swelling following human cerebral contusion: an ultrastructural study. J Neurol Neurosurg Psychiatry 54(5):427–434
Jha RM, Elmer J, Zusman BE (2018) Intracranial pressure trajectories: a novel approach to informing severe traumatic brain injury phenotypes. Crit Care Med 46(11):1792–1802. https://doi.org/10.1097/CCM.0000000000003361
Bhowmick S, D’Mello V, Caruso D et al (2019) Impairment of pericyte–endothelium cross-talk leads to blood–brain barrier dysfunction following traumatic brain injury. Exp Neurol 317:260–270. https://doi.org/10.1016/j.expneurol.2019.03.014
Carpenter K, Czosnyka M, Jalloh I (2015) Systemic, local, and imaging biomarkers of brain injury: more needed, and better use of those already established? Front Neurol 6:26
Acknowledgments
Alex Trofimov was supported by a grant-in-aid for exploratory research from the Privolzhsky Research Medical University. Denis Bragin was supported by National Institutes of Health grant number R01NS112808-01.
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Trofimov, A. et al. (2021). Microcirculatory Biomarkers of Secondary Cerebral Ischemia in Traumatic Brain Injury. In: Depreitere, B., Meyfroidt, G., Güiza, F. (eds) Intracranial Pressure and Neuromonitoring XVII. Acta Neurochirurgica Supplement, vol 131. Springer, Cham. https://doi.org/10.1007/978-3-030-59436-7_1
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