Transcranial doppler sonography in two patients who underwent decompressive craniectomy for traumatic brain swelling: report of two cases

Arquivos de Neuro-Psiquiatria

Edson Bor-seng-shu²  Manoel Jacobsen Teixeira²  Roberto Hirsch¹  Almir Ferreira De Andrade²  Raul Marino Jr² 

[1] ,São Paulo University Medical School Hospital das Clínicas Division of NeurosurgerySão Paulo SP ,Brazil

关键词: brain swelling;    cerebral hemodynamics;    decompressive craniectomy;    head injury;    intracranial hypertension;    transcranial Doppler sonography;    tumefação encefálica;    hemodinâmica cerebral;    craniectomia descompressiva;    traumatismo craniencefálico;    hipertensão intracraniana;    doppler transcraniano;   

DOI  :  10.1590/S0004-282X2004000400028

来源: SciELO

【 摘 要 】

The role of decompressive craniectomy in the treatment of severe posttraumatic cerebral swelling remains quite a controversial issue. To the best of our knowledge, there is no study demonstrating the effect of decompressive craniectomy on cerebral blood flow (CBF) velocity by means of transcranial Doppler sonography (TCD). We present two patients who developed traumatic brain swelling and uncontrollable intracranial hypertension with coma and signs of transtentorial herniation. One patient underwent bifrontal, while the second, unilateral, frontotemporoparietal decompressive craniectomy with dural expansion. In both patients, TCD examinations were performed immediately before and after surgery to study the cerebral hemodynamic changes related to the operations. Pre and postoperative TCD examinations demonstrated a significant increase in blood flow velocity in the intracranial arteries in both subjects. In conclusion, our cases suggest that decompressive craniectomy with dural expansion may result in elevation of CBF velocity in patients with massive brain swelling. The increase in CBF velocity appears to occur not only in the decompressed hemisphere, but also on the opposite side.

【 授权许可】

CC BY   
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