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Perfusion tomography in early follow-up of acute traumatic subdural hematoma: a case series.
Amorim, Robson Luís; da Silva, Vinicius Trindade; Martins, Henrique Oliveira; Brasil, Sérgio; Godoy, Daniel Agustín; Mendes, Matheus Teixeira; Gattas, Gabriel; Bor-Seng-Shu, Edson; Paiva, Wellingson Silva.
Afiliação
  • Amorim RL; LIM-62, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
  • da Silva VT; Health Sciences Faculty, Federal University of Amazonas, Manaus, Brazil.
  • Martins HO; LIM-62, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil.
  • Brasil S; Health Sciences Faculty, Federal University of Amazonas, Manaus, Brazil.
  • Godoy DA; LIM-62, Department of Neurology, University of São Paulo Medical School, São Paulo, Brazil. sbrasil@usp.br.
  • Mendes MT; Division of Neurosurgery, University of São Paulo, 255. Eneas de Carvalho Aguiar Av., São Paulo, 05403-000, Brazil. sbrasil@usp.br.
  • Gattas G; Critical Care Department, Division Neurocritical Care, Sanatorio Pasteur, Catamarca, Argentina. dagodoytorres@yahoo.com.ar.
  • Bor-Seng-Shu E; Neurointensive Care Unit, Sanatorio Pasteur. Chacabuco 747, Catamarca, 4700, Argentina. dagodoytorres@yahoo.com.ar.
  • Paiva WS; Health Sciences Faculty, Federal University of Amazonas, Manaus, Brazil.
J Clin Monit Comput ; 38(4): 783-789, 2024 Aug.
Article em En | MEDLINE | ID: mdl-38381360
ABSTRACT
Perfusion Computed Tomography (PCT) is an alternative tool to assess cerebral hemodynamics during trauma. As acute traumatic subdural hematomas (ASH) is a severe primary injury associated with poor outcomes, the aim of this study was to evaluate the cerebral hemodynamics in this context. Five adult patients with moderate and severe traumatic brain injury (TBI) and ASH were included. All individuals were indicated for surgical evacuation. Before and after surgery, PCT was performed and cerebral blood flow (CBF), cerebral blood volume (CBV) and mean transit time (MTT) were evaluated. These parameters were associated with the outcome at 6 months post-trauma with the extended Glasgow Outcome Scale (GOSE). Mean age of population was 46 years (SD 8.1). Mean post-resuscitation Glasgow coma scale (GCS) was 10 (SD 3.4). Mean preoperative midline brain shift was 10.1 mm (SD 1.8). Preoperative CBF and MTT were 23.9 ml/100 g/min (SD 6.1) and 7.3 s (1.3) respectively. After surgery, CBF increase to 30.7 ml/100 g/min (SD 5.1), and MTT decrease to 5.8s (SD1.0), however, both changes don't achieve statistically significance (p = 0.06). Additionally, CBV increase after surgery, from 2.34 (SD 0.67) to 2.63 ml/100 g (SD 1.10), (p = 0.31). Spearman correlation test of postoperative and preoperative CBF ratio with outcome at 6 months was 0.94 (p = 0.054). One patient died with the highest preoperative MTT (9.97 s) and CBV (4.51 ml/100 g). CBF seems to increase after surgery, especially when evaluated together with the MTT values. It is suggested that the improvement in postoperative brain hemodynamics correlates to favorable outcome.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tomografia Computadorizada por Raios X / Escala de Coma de Glasgow / Circulação Cerebrovascular / Hematoma Subdural Agudo / Lesões Encefálicas Traumáticas Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Monit Comput Assunto da revista: INFORMATICA MEDICA / MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda
Texto completo
Adicionar na Minha BVS
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Tomografia Computadorizada por Raios X / Escala de Coma de Glasgow / Circulação Cerebrovascular / Hematoma Subdural Agudo / Lesões Encefálicas Traumáticas Limite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: J Clin Monit Comput Assunto da revista: INFORMATICA MEDICA / MEDICINA Ano de publicação: 2024 Tipo de documento: Article País de afiliação: Brasil País de publicação: Holanda