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Vol. 18. Issue 3.
Pages 221-226 (January 2007)
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Vol. 18. Issue 3.
Pages 221-226 (January 2007)
Hemodinámica cerebral en pacientes con traumatismo craneoencefálico evaluada por doppler transcraneal y duplex transcraneal con codificación en color. Estudio comparativo
Cerebral hemodynamics in patients with traumatic brain injury evaluated by transcranial doppler and transcranial color coded sonography. A comparison study
Visits
1802
J. Homar
, J.Mª. Abadal, J.A. Llompart-Pou, J. Pérez-Bárcena, J. Ibáñez
Servicio de Medicina Intensiva. Hospital Universitario Son Dureta. Palma de Mallorca
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Resumen
Objetivos

Comparar el número de vasos identificados y las velocidades e índices de pulsatilidad de los mismos mediante doppler transcraneal (DTC) y dúplex transcraneal codificado en color (DTCC) en una población de enfermos con traumatismo craneoencefálico (TCE).

Material y métodos

Se estudiaron 30 enfermos ingresados por TCE en una Unidad de Cuidados Intensivos (UCI) neurocríticos. Consecutivamente se realizaron estudios mediante DTC y DTCC. Se compararon la tasa de insonación de las arterias del polígono de Willis y los parámetros hemodinámicos obtenidos.

Resultados

La edad media fue de 50 años. El 67% fueron varones. En el estudio mediante DTCC se insonó la arteria carótida interna en un 95% de los casos, la arteria cerebral media (ACM) en el 95% de las ocasiones, la arteria cerebral anterior (ACA) en un 91% y la arteria cerebral posterior (ACP) en un 92% de los estudios. Mediante DTC convencional se hallaron en un 29%, 93%, 67% y 35% respectivamente. La velocidad media mediante DTCC y DTC en la ACM fue de 79cm/ seg vs 59cm/seg respectivamente (p<0.0001), en la ACA de 61cm/seg vs 42cm/seg (p<0.0001) y en la ACP de 43cm/seg y 33cm/seg (p<0.0001).

Conclusiones

El DTCC permite un estudio hemodinámico más completo en los enfermos con TCE ingresados en la UCI. Su impacto en el pronóstico del TCE deberá determinarse en próximos estudios.

Palabras clave:
Dúplex transcraneal codificado en color
Doppler transcraneal
Traumatismo craneoencefálico
Hemodinámica cerebral
Abreviaturas:
ACA
ACA
ACM
ACP
DTC
DTCC
ECVA
ICU
MCA
PCA
TBI
TCCS
TCD
TCE
UCI
Summary
Objective

To compare the number of vessels identified and mean velocity and pulsatility index values obtained by transcranial doppler (TCD) and transcranial color coded sonography (TCCS) in patients with traumatic brain injury (TBI).

Methods

Thirty patients suffering from TBI admitted in our neurocritical Intensive Care Unit (ICU) were studied. We performed consecutive studies by TCD and TCCS. The number of Circle of Willis vessels insonated and the hemodynamic parameters were compared.

Results

Mean age was 50 years. Twenty patients were male. By using TCCS, internal carotid artery was insonated in 95%, middle cerebral artery (MCA) in 95%, anterior cerebral artery (ACA) in 91% and posterior cerebral artery (PCA) in 92% of the studies. Using conventional TCD they were insonated in 29%, 93% 67% and 35% of the studies respectively. Mean velocity values measured by CCS and TCD in MCA were 79cm/sec vs 59cm/sec respectively (p<0.0001), in ACA were 61cm/sec vs 42cm/sec (p<0.0001) and in PCA were 43cm/sec vs 33cm/sec (p<0.0001).

Conclusion

TCCS allows a high quality hemodynamic study of TBI patients admitted to the ICU. Further studies must define its impact on outcome of TBI patients.

Key words:
Transcranial color coded sonography
Transcranial doppler
Traumatic brain injury
Cerebral hemodynamics

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