Cerebral hemodynamic changes after wartime traumatic brain injury

Alexander Razumovsky; Teodoro Tigno; Sven M. Hochheimer; Fred L. Stephens; Randy Bell; Alexander H. Vo; Meryl A. Severson; Scott A. Marshall; Stephen M. Oppenheimer; Robert Ecker; Rocco A. Armonda

doi:10.1007/978-3-7091-1192-5-19

Cerebral hemodynamic changes after wartime traumatic brain injury

Alexander Razumovsky, Teodoro Tigno, Sven M. Hochheimer, Fred L. Stephens, Randy Bell, Alexander H. Vo, Meryl A. Severson, Scott A. Marshall, Stephen M. Oppenheimer, Robert Ecker, Rocco A. Armonda

Research output: Chapter in Book/Report/Conference proceeding › Conference contribution

Abstract

Traumatic brain injury (TBI) is associated with the severest casualties from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). From October 1, 2008, the U.S. Army Medical Department initiated a transcranial Doppler (TCD) ultrasound service for TBI; included patients were retrospectively evaluated for TCD-determined incidence of post-traumatic cerebral vasospasm and intracranial hypertension after wartime TBI. Ninety patients were investigated with daily TCD studies and a comprehensive TCD protocol, and published diagnostic criteria for vasospasm and increased intracranial pressure (ICP) were applied. TCD signs of mild, moderate, and severe vasospasms were observed in 37%, 22%, and 12% of patients, respectively. TCD signs of intracranial hypertension were recorded in 62.2%; 5 patients (4.5%) underwent transluminal angioplasty for post-traumatic clinical vasospasm treatment, and 16 (14.4%) had cranioplasty. These findings demonstrate that cerebral arterial spasm and intracranial hypertension are frequent and significant complications of combat TBI; therefore, daily TCD monitoring is recommended for their recognition and subsequent management.

Original language	English (US)
Title of host publication	Acta Neurochirurgica, Supplementum
Pages	87-90
Number of pages	4
Edition	115
DOIs	https://doi.org/10.1007/978-3-7091-1192-5-19
State	Published - 2013
Externally published	Yes

Publication series

Name	Acta Neurochirurgica, Supplementum
Number	115
ISSN (Print)	00651419
ISSN (Electronic)	00016268

Keywords

Cerebral blood flow velocity
Combat-associated wartime traumatic brain injury
Intracranial pressure
Transcranial Doppler ultrasonography
Vasospasm
Wartime traumatic brain injury

ASJC Scopus subject areas

Clinical Neurology
Surgery

Access to Document

10.1007/978-3-7091-1192-5-19

Cite this

Razumovsky, A., Tigno, T., Hochheimer, S. M., Stephens, F. L., Bell, R., Vo, A. H., Severson, M. A., Marshall, S. A., Oppenheimer, S. M., Ecker, R., & Armonda, R. A. (2013). Cerebral hemodynamic changes after wartime traumatic brain injury. In Acta Neurochirurgica, Supplementum (115 ed., pp. 87-90). (Acta Neurochirurgica, Supplementum; No. 115). https://doi.org/10.1007/978-3-7091-1192-5-19

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title = "Cerebral hemodynamic changes after wartime traumatic brain injury",

abstract = "Traumatic brain injury (TBI) is associated with the severest casualties from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). From October 1, 2008, the U.S. Army Medical Department initiated a transcranial Doppler (TCD) ultrasound service for TBI; included patients were retrospectively evaluated for TCD-determined incidence of post-traumatic cerebral vasospasm and intracranial hypertension after wartime TBI. Ninety patients were investigated with daily TCD studies and a comprehensive TCD protocol, and published diagnostic criteria for vasospasm and increased intracranial pressure (ICP) were applied. TCD signs of mild, moderate, and severe vasospasms were observed in 37%, 22%, and 12% of patients, respectively. TCD signs of intracranial hypertension were recorded in 62.2%; 5 patients (4.5%) underwent transluminal angioplasty for post-traumatic clinical vasospasm treatment, and 16 (14.4%) had cranioplasty. These findings demonstrate that cerebral arterial spasm and intracranial hypertension are frequent and significant complications of combat TBI; therefore, daily TCD monitoring is recommended for their recognition and subsequent management.",

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author = "Alexander Razumovsky and Teodoro Tigno and Hochheimer, {Sven M.} and Stephens, {Fred L.} and Randy Bell and Vo, {Alexander H.} and Severson, {Meryl A.} and Marshall, {Scott A.} and Oppenheimer, {Stephen M.} and Robert Ecker and Armonda, {Rocco A.}",

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doi = "10.1007/978-3-7091-1192-5-19",

language = "English (US)",

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AU - Razumovsky, Alexander

AU - Tigno, Teodoro

AU - Hochheimer, Sven M.

AU - Stephens, Fred L.

AU - Bell, Randy

AU - Vo, Alexander H.

AU - Severson, Meryl A.

AU - Marshall, Scott A.

AU - Oppenheimer, Stephen M.

AU - Ecker, Robert

AU - Armonda, Rocco A.

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AB - Traumatic brain injury (TBI) is associated with the severest casualties from Operation Iraqi Freedom (OIF) and Operation Enduring Freedom (OEF). From October 1, 2008, the U.S. Army Medical Department initiated a transcranial Doppler (TCD) ultrasound service for TBI; included patients were retrospectively evaluated for TCD-determined incidence of post-traumatic cerebral vasospasm and intracranial hypertension after wartime TBI. Ninety patients were investigated with daily TCD studies and a comprehensive TCD protocol, and published diagnostic criteria for vasospasm and increased intracranial pressure (ICP) were applied. TCD signs of mild, moderate, and severe vasospasms were observed in 37%, 22%, and 12% of patients, respectively. TCD signs of intracranial hypertension were recorded in 62.2%; 5 patients (4.5%) underwent transluminal angioplasty for post-traumatic clinical vasospasm treatment, and 16 (14.4%) had cranioplasty. These findings demonstrate that cerebral arterial spasm and intracranial hypertension are frequent and significant complications of combat TBI; therefore, daily TCD monitoring is recommended for their recognition and subsequent management.

KW - Cerebral blood flow velocity

KW - Combat-associated wartime traumatic brain injury

KW - Intracranial pressure

KW - Transcranial Doppler ultrasonography

KW - Vasospasm

KW - Wartime traumatic brain injury

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Cerebral hemodynamic changes after wartime traumatic brain injury

Abstract

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Keywords

ASJC Scopus subject areas

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