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Cerebral Arterial Compliance in Polytraumazed Patients with Cerebral Vasospasm

  • Alex Trofimov
  • Michael Dobrzeniecki
  • Denis E. Bragin
Chapter
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 127)

Abstract

The purpose was to determine the status of the cerebral arterial compliance (cAC) in a concomitant head injury and cerebral vasospasm (CVS) with and without the development of intracranial hematomas (ICH). In Materials and Methods, we examined 80 polytrauma patients with severe TBI and CVS. During or immediately after dynamic helical computed tomography angiography (DHCTA), the monitoring of the transcranial Doppler of the MCA was recorded bilaterally with 2-MHz probes. The cerebral blood volumes were calculated from the DHCTA data with complex mathematical procedures using the “direct flow model” algorithm. In Results, CAC was significantly decreased (p < 0.001) in both the first and second group TBI and CVS (with or without ICH) in comparison with normal data (p < 0.001) and TBI without CVS. The cAC was significantly decreased on the side of the former hematoma with CVS than on the contralateral side with CVS (р = 0.003). In Conclusion, the cAC in TBI and CVS gets significantly lower as compared to the normal condition (p < 0.001). After removal of the ICH and development of CVS, the compliance in the perifocal zone remains much lower (р = 0.003) as compared to compliance of the other brain hemisphere.

Keywords

Cerebral arterial compliance Cerebral vasospasm Intracranial hematomas Traumatic brain injury 

Notes

Acknowledgments

D.B. was supported by NIH P20GM109089, DOD DM160142 and RSF No. 17-15-01263.

Conflict of Interest: We declare that we have no conflicts of interest.

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Alex Trofimov
    • 1
    • 2
  • Michael Dobrzeniecki
    • 3
  • Denis E. Bragin
    • 4
  1. 1.Department of NeurosurgeryNizhny Novgorod State Medical AcademyNizhny NovgorodRussia
  2. 2.Department of PolytraumaRegional Hospital Named After N.A. SemashkoNizhny NovgorodRussia
  3. 3.Department of NeurosurgerySpine Surgery and Interventional Neuroradiology DONAUISAR Klinikum DeggendorfDeggendorfGermany
  4. 4.Department of NeurosurgeryUniversity of New Mexico School of MedicineAlbuquerqueUSA

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