TY - GEN
T1 - Cerebral hemodynamic changes after wartime traumatic brain injury
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.
PY - 2013
Y1 - 2013
N2 - 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.
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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U2 - 10.1007/978-3-7091-1192-5_19
DO - 10.1007/978-3-7091-1192-5_19
M3 - Conference contribution
C2 - 22890651
AN - SCOPUS:85052608682
SN - 9783709111918
T3 - Acta Neurochirurgica, Supplementum
SP - 87
EP - 90
BT - Cerebral Vasospasm
PB - Springer-Verlag Wien
ER -