Biomaterial Database

Prognostic significance of altered cerebral blood flow velocity in acute head trauma. 1997

E J Lee, and C C Chio, and C H Chang, and H H Chen

Department of Surgery, National Cheng Kung University Medical Center, Tainan, Taiwan ROC.

From July 1992 to January 1993, 31 patients with acute closed head injuries underwent blood flow velocity (BFV) measurement in the middle cerebral artery by transcranial Doppler ultrasound. Eighteen patients had abnormal changes of BFV (group A) and 13 patients had normal BFV (group B). In group A, there were eight deaths (44%) and the Glasgow Outcome Scale score was 2.6 +/- 0.4 (mean +/- SEM). On admission, 14 group A patients had decreased BFV, including nine patients with evidence of early cerebral circulatory arrest (CCA). During hospitalization, eight group. A patients were diagnosed with global hyperemia, including two patients who had early CCA. Another six in group A had ultrasound recordings consistent with vasospasm, and three of these six also experienced early CCA. The renaming four patients in group A had persistently low BFV, progressing from early CCA. In group B there were two deaths (15%) and the mean Glasgow Outcome Scale score was 4.0 +/- 0.5. Group A had higher mortality (Fisher's exact test, p = 0.128) and a significantly higher rate of unfavorable functional outcome than group B. To evaluate the prognostic significance of these BFV changes, group A was subdivided into global hyperemia, vasopasm and early CCA subgroups. Both the vasospasm and early CCA subgroups had significantly lower Glasgow Coma Scale scores on admission and a higher rate of unfavorable functional outcomes than group B. All five survivors with vasospasm and/or early CCA showed ischemic morbidity on follow-up cranial computed tomography; though those with global hyperemia did not. There were no significant differences in the Glasgow Coma Scale score on admission, mortality or functional outcome between global hyperemia patients and group B patients. Global hyperemia may represent a recovery stage of impaired cerebral hemodynamics. This stage may occur transiently and has no major impact on morbidity or mortality. Vasospasm and early CCA may be closely related to ischemic complications, and may provide clinical information for selecting appropriate therapy in acute head trauma.

UI	MeSH Term	Description	Entries
D008875	Middle Aged	An adult aged 45 - 64 years.	Middle Age
D011379	Prognosis	A prediction of the probable outcome of a disease based on a individual's condition and the usual course of the disease as seen in similar situations.	Prognostic Factor,Prognostic Factors,Factor, Prognostic,Factors, Prognostic,Prognoses
D001783	Blood Flow Velocity	A value equal to the total volume flow divided by the cross-sectional area of the vascular bed.	Blood Flow Velocities,Flow Velocities, Blood,Flow Velocity, Blood,Velocities, Blood Flow,Velocity, Blood Flow
D002560	Cerebrovascular Circulation	The circulation of blood through the BLOOD VESSELS of the BRAIN.	Brain Blood Flow,Regional Cerebral Blood Flow,Cerebral Blood Flow,Cerebral Circulation,Cerebral Perfusion Pressure,Circulation, Cerebrovascular,Blood Flow, Brain,Blood Flow, Cerebral,Brain Blood Flows,Cerebral Blood Flows,Cerebral Circulations,Cerebral Perfusion Pressures,Circulation, Cerebral,Flow, Brain Blood,Flow, Cerebral Blood,Perfusion Pressure, Cerebral,Pressure, Cerebral Perfusion
D006259	Craniocerebral Trauma	Traumatic injuries involving the cranium and intracranial structures (i.e., BRAIN; CRANIAL NERVES; MENINGES; and other structures). Injuries may be classified by whether or not the skull is penetrated (i.e., penetrating vs. nonpenetrating) or whether there is an associated hemorrhage.	Frontal Region Trauma,Head Injuries,Head Trauma,Occipital Region Trauma,Parietal Region Trauma,Temporal Region Trauma,Craniocerebral Injuries,Crushing Skull Injury,Forehead Trauma,Head Injuries, Multiple,Head Injury, Minor,Head Injury, Open,Head Injury, Superficial,Injuries, Craniocerebral,Injuries, Head,Multiple Head Injuries,Occipital Trauma,Open Head Injury,Superficial Head Injury,Trauma, Head,Craniocerebral Injury,Craniocerebral Traumas,Crushing Skull Injuries,Forehead Traumas,Frontal Region Traumas,Head Injuries, Minor,Head Injuries, Open,Head Injuries, Superficial,Head Injury,Head Injury, Multiple,Head Traumas,Injuries, Minor Head,Injuries, Multiple Head,Injuries, Open Head,Injuries, Superficial Head,Injury, Craniocerebral,Injury, Head,Injury, Minor Head,Injury, Multiple Head,Injury, Open Head,Injury, Superficial Head,Minor Head Injuries,Minor Head Injury,Multiple Head Injury,Occipital Region Traumas,Occipital Traumas,Open Head Injuries,Parietal Region Traumas,Region Trauma, Frontal,Region Trauma, Occipital,Region Trauma, Parietal,Region Traumas, Frontal,Region Traumas, Occipital,Region Traumas, Parietal,Skull Injuries, Crushing,Skull Injury, Crushing,Superficial Head Injuries,Temporal Region Traumas,Trauma, Craniocerebral,Trauma, Forehead,Trauma, Frontal Region,Trauma, Occipital,Trauma, Occipital Region,Trauma, Parietal Region,Trauma, Temporal Region,Traumas, Craniocerebral,Traumas, Forehead,Traumas, Frontal Region,Traumas, Head,Traumas, Occipital,Traumas, Occipital Region,Traumas, Parietal Region,Traumas, Temporal Region
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000208	Acute Disease	Disease having a short and relatively severe course.	Acute Diseases,Disease, Acute,Diseases, Acute
D000293	Adolescent	A person 13 to 18 years of age.	Adolescence,Youth,Adolescents,Adolescents, Female,Adolescents, Male,Teenagers,Teens,Adolescent, Female,Adolescent, Male,Female Adolescent,Female Adolescents,Male Adolescent,Male Adolescents,Teen,Teenager,Youths
D000328	Adult	A person having attained full growth or maturity. Adults are of 19 through 44 years of age. For a person between 19 and 24 years of age, YOUNG ADULT is available.	Adults
D000368	Aged	A person 65 years of age or older. For a person older than 79 years, AGED, 80 AND OVER is available.	Elderly