Cerebral hemodynamic changes after wartime traumatic brain injury

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

Research output: Chapter in Book/Report/Conference proceedingConference contribution

11 Scopus citations

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 languageEnglish (US)
Title of host publicationCerebral Vasospasm
Subtitle of host publicationNeurovascular Events After Subarachnoid Hemorrhage
PublisherSpringer-Verlag Wien
Pages87-90
Number of pages4
Edition115
ISBN (Print)9783709111918
DOIs
StatePublished - Jan 1 2013

Publication series

NameActa Neurochirurgica, Supplementum
Number115
ISSN (Print)0065-1419
ISSN (Electronic)0001-6268

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

  • Surgery
  • Clinical Neurology

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  • Cite this

    Razumovsky, A., Tigno, T., Hochheimer, S. M., Stephens, F. L., Bell, R., Vo, A., Severson, M. A., Marshall, S. A., Oppenheimer, S. M., Ecker, R., & Armonda, R. A. (2013). Cerebral hemodynamic changes after wartime traumatic brain injury. In Cerebral Vasospasm: Neurovascular Events After Subarachnoid Hemorrhage (115 ed., pp. 87-90). (Acta Neurochirurgica, Supplementum; No. 115). Springer-Verlag Wien. https://doi.org/10.1007/978-3-7091-1192-5_19