الفهرس | Only 14 pages are availabe for public view |
Abstract Head trauma initiates several pathologic processes, among which changes in cerebral hemodynamics . Timely and accurate recognition of cerebrovascular abnormalities is critical for diagnosis , management , and outcome prediction of head injury. The introduction of Transcranial Doppler Ultrasonography provided a non invasive technique for investigation of the vascular component of intracranial pathologic conditions . Unlike cerebral angiography , TCD does not provide information about intracranial vascular morphology . Cerebral blood flow velocities and other parameters derived from TCD , however have proved to be valuable in several conditions including brain death , increase ICP , hyperemia , cerebral ischemia , and vasospasm . We studied 92 closed head trauma patients with age range between 18 to 60 years old admitted in SICU at the Emergency Hospital, Mansoura University . Patients with open head injury , brain herniation , persistent shock after 24 hours , history of systemic or neurologic diseases , inability to perform TCD examination and presence of bandage over the temporal window were excluded . Patients were grouped according to initial CT findings : DI I ( Patients with no CT findings ) , DI II ( Patients with brain edema on CT ) , DI III ( Patients with SAH on CT ) , DI IV ( Patients with midline shift more than 5 mm) , Evacuated mass ( Patients who had any mass which was surgically evacuated) and NonEvacuated mass ( Patients with mass more than 25 cc and was not evacuated). Initial resuscitation and assessment were done and the patients were transported to SICU where they were monitored and stabilized . TCD examination was done daily in the morning . Data was recorded and analyzed in the end of the study. |