Posttraumatic vasospasm and intracranial hypertension after wartime traumatic brain injury

Rocco A. Armondaa, Teodoro A. Tignob, Sven M. Hochheimera, Fred L. Stephensa, Randy S. Bell, Alexander H. Vo, Meryl A. Severson, Scott A. Marshall, Stephen M. Oppenheimer, Robert Ecker, Alexander Razumovsky

Research output: Contribution to journalArticle

3 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 US Army Medical Department initiated a transcranial Doppler (TCD) ultrasound service for TBI patients; included patients were retrospectively evaluated for TCD-determined incidence of posttraumatic cerebral vasospasm and intracranial hypertension after wartime TBI. Ninety patients were investigated with daily TCD studies and comprehensive TCD protocol and published diagnostic criteria for vasospasm and raised 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%, five 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)
Pages (from-to)261-264
Number of pages4
JournalPerspectives in Medicine
Volume1-12
DOIs
StatePublished - Sep 2012

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

  • Medicine(all)

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  • Cite this

    Armondaa, R. A., Tignob, T. A., Hochheimera, S. M., Stephensa, F. L., Bell, R. S., Vo, A. H., Severson, M. A., Marshall, S. A., Oppenheimer, S. M., Ecker, R., & Razumovsky, A. (2012). Posttraumatic vasospasm and intracranial hypertension after wartime traumatic brain injury. Perspectives in Medicine, 1-12, 261-264. https://doi.org/10.1016/j.permed.2012.02.043