Evaluation of Closed Head Injury Patients Using Transcranial Doppler Monitoring

Continuous recording of basal cerebral artery velocities using transcranial Doppler may provide a more practical alternative to CBF methods for the assessment of cerebrovascular responses in patients with head injury and other neurological conditions requiring ICP management. A method is described where continuous recordings of blood flow velocity (BFV), arterial blood pressure (ABP), intracranial pressure (ICP), and end tidal CO2 (Et CO2) are obtained by portable equipment which can easily be taken to the ICU. This unit can then be used to test blood flow response to CO2 changes, autoregulation, response to barbiturates and response to mannitol therapy. By obtaining information on the effectiveness of these responses in head injury patients, it may be feasible to use this information to guide therapy.