Branko Radanović

Assessment of intra-cranial pressure after severe traumatic brain injury by transcranial Doppler ultrasonography.

Primary objective: To investigate the potential of transcranial Doppler ultrasonography in estimating post-traumatic intra-cranial pressure early after severe traumatic brain injury. Research design: The group of 24 patients was analysed for the observation of an early post-traumatic cerebral haemodynamic by middle cerebral artery blood velocity measuring. Methods and procedures: The standard method of measuring the mean blood middle cerebral artery velocity by transcranial Doppler ultrasonic device was performed. Main outcomes and results: The increased duration of intra-cranial hypertension correlated to the middle cerebral artery low blood velocity (p = 0.042; r = −0.498) (n = 17) and to elevated pulsatility indices (p = 0.007; r = 0.753) (n = 11) significantly. The increased duration of lowered cerebral perfusion pressure correlated to the middle cerebral artery low blood velocity significantly (p = 0.001; r = −0.619) (n = 24). Conclusions: The significance of transcranial Doppler ultrasonography as a method to estimate an early post-traumatic intra-cranial pressure after severe brain injury was confirmed. This simple and non-invasive technique could be easily used in daily clinical practice and precede intra-cranial pressure monitoring in selected patients.

4-37-01 Functional tests in the TCD analysis of the vertebrobasilar circulation

The study reviewed patients suffering from vertebrobasilar disorders - 38 patients experienced them after changing the head position, followed by 57 patients who had them resting - and the group of 59 healthy examinees. The transcranial Doppler (TCD) was used to measure the mean velocity (cm/s) of intracranial parts of vertebral and basilar arteries. The measuring was per-formed having the head in its physiological position, followed by the provoking test positions. The radiological neck spine findings were analyzed, and the electronistagmography and heat experiment were performed. The study results showed the significant changes of mean velocity in verte-bral arteries and basilar arteries intracranial parts, in patients comparing them to healthy group. The circulation velocity changes were more significant in the patients suffering from the vertebrobasilar disorders evident after assuming the head provoking positions than in the group of patients who had them resting. The result analysis obtained in the group of the patients with vertebrobasilar disorders, who were in the provoking position, suggest that the circulation disor-ders are related to the head positions and can be detected applying the Doppler circulation velocity measuring in the vertebral arteries, whereas the radiological finding of the neck spine showed far less visible changes in comparison to the healthy group. In the group of the vertebrobasilar patients, who were resting, the result analysis did not show any correlation between the disorders and circulation changes, that can be detected by Doppler circulation velocity mea-suring nor was the radiological neck spine finding of any importance, when we differentiated the sick ones from the healthy ones. The electronistagmographic finding and heat experiment did not help to detect and divide the patients with the vertebrobasilar disorders.