Back to Search
Start Over
Direct observation during surgery shows preservation of cerebral microcirculation in patients with traumatic brain injury
- Source :
- Journal of the neurological sciences, 353(1-2), 38-43. Elsevier
- Publication Year :
- 2015
-
Abstract
- Objective To describe the alterations of the cortical microcirculation of the brain (blood flow and vessel density) in TBI patients who and compare them with a control group. Methods Prospective and observational study in a third-level university hospital. Cortical microcirculation in the brain was directly observed using sidestream dark-field (SDF) imaging in 14 patients who underwent surgery: 5 subdural hematomas (SDH) and 9 parenchymal lesions (contusions/hematomas). In this last set of patients, images were recorded in the “pericontusional” areas and in the “surrounding” brain (areas that were as far from the lesion as the craniotomy allowed). These patients were compared to five patients who underwent craniotomy for a disease that did not affect the cortex. Results There were fewer “pericontusional” images that could be analyzed due to the presence of subarachnoid hemorrhage. The proportion or perfused vessels was similar in all groups: control 99.5% ± 1.3%; SDH 98.6% ± 2.4%; “pericontusional” area 98.2% ± 2.4%; “surrounding” area 98.4% ± 2.5% (p = 0.145). The perfused vessel density index was smaller in the “pericontusional” area: control 6.5 ± 1.6 l/mm; SDH 6.5 ± 2.5 l/mm; “pericontusional” area 5.4 ± 2.6 l/mm; “surrounding” 6.6 ± 2.1 l/mm (p = 0.07). Conclusions Although the analysis of pericontusional zone was difficult, there were fewer vessels than in the controls and there was no change in the flow. In the surrounding zone and in patients with SDH, we did not document alterations in the microcirculation. Direct imaging of cerebral microcirculation in TBI patients showed that despite serious brain injury the cerebral microcirculation was remarkably well preserved.
- Subjects :
- Adult
Diagnostic Imaging
Male
medicine.medical_specialty
Subarachnoid hemorrhage
Traumatic brain injury
medicine.medical_treatment
Blood Pressure
Statistics, Nonparametric
Microcirculation
Lesion
Heart Rate
medicine
Humans
Prospective Studies
Cerebral perfusion pressure
Craniotomy
Aged
Intracranial pressure
Intraoperative Care
business.industry
Middle Aged
medicine.disease
Surgery
Neurology
Cerebral blood flow
Brain Injuries
Cerebrovascular Circulation
Anesthesia
Female
Neurology (clinical)
medicine.symptom
business
Subjects
Details
- Language :
- English
- ISSN :
- 0022510X
- Volume :
- 353
- Issue :
- 1-2
- Database :
- OpenAIRE
- Journal :
- Journal of the neurological sciences
- Accession number :
- edsair.doi.dedup.....9c973a56eb08a618721ea524189a5efc