HOMEPRODUCTSCOMPANYCONTACTFAQResearchDictionaryPharmaSign Up FREE or Login

Haemodynamic patterns in children with posttraumatic diffuse brain swelling. A preliminary study in 6 cases with neuroradiological features consistent with diffuse axonal injury.

AbstractBACKGROUND:
In the present report we describe the cerebral haemodynamics and the neuroradiological findings observed in six consecutive children, three males and three females aged 4-15.6 yrs (mean age 8.95) displaying a neuroradiological pattern consistent with diffuse axonal injury (DAI) along with slit ventricles.
METHODS:
All the patients were admitted to the Paediatric Intensive Care Unit with GCS scores less than 8 after a severe brain injury. Serial head computed to mography (CT) and magnetic resonance (MR) scans demonstrated a radiological pattern of DAI. Transcranial Doppler Sonography (TCD) of the middle cerebral arteries was performed through the temporal bone window in all the patients. All patients but one underwent a continuous monitoring of intracranial pressure (ICP) and cerebral extraction of O(2) (CEO(2)). Treatment with barbiturates and hyperventilation was necessary in all the cases. In one patient, a bilateral decompressive cran iectomy was performed in order to decrease severe in tracranial hypertension.
RESULTS:
Hyperflow along with intracranial hyper tension, variably responsive to barbiturate medication, was observed in all the patients by means of TCD and CEO(2).
CONCLUSIONS:
Intracranial hypertension can be elevated in pediatric posttraumatic hyperflow syndromes associated with DAI. The observation of the time course of the parameters studied allowed us to modify the pharmacological treatment and/or perform surgical decompression (external cerebrospinal fluid (CSF) drainage in five cases; decompressive craniectomy in one case). Compartmental hyperflow TCD pattern was evident in only one patient. Although the limited number of pa tients in our series does not allow definite conclusions, we strongly believe that TCD, with ICP and CEO(2) monitoring, are useful tools in planning surgical strategy in children with neuroradiological signs of DAI.
AuthorsM Visocchi, A Chiaretti, O Genovese, F Di Rocco
JournalActa neurochirurgica (Acta Neurochir (Wien)) Vol. 149 Issue 4 Pg. 347-56 ( 2007) ISSN: 0001-6268 [Print] Austria
PMID17426998 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Topics
  • Adolescent
  • Age Factors
  • Brain (growth & development, physiopathology)
  • Brain Edema (diagnostic imaging, physiopathology)
  • Brain Injuries (diagnostic imaging, physiopathology)
  • Cerebrovascular Circulation (physiology)
  • Child
  • Child, Preschool
  • Craniotomy
  • Decompression, Surgical
  • Diffuse Axonal Injury (diagnostic imaging, physiopathology)
  • Disease Progression
  • Female
  • Humans
  • Intracranial Hypertension (etiology, physiopathology, surgery)
  • Magnetic Resonance Imaging
  • Male
  • Middle Cerebral Artery (diagnostic imaging)
  • Neurosurgical Procedures
  • Pilot Projects
  • Predictive Value of Tests
  • Time Factors
  • Tomography, X-Ray Computed
  • Ultrasonography, Doppler, Transcranial

Join CureHunter, for free Research Interface BASIC access!

Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease. Find out why thousands of doctors, pharma researchers and patient activists around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!


Choose Username:
Email:
Password:
Verify Password:
Enter Code Shown: