Vakilian Alireza, Iranmanesh Farhad
Department of Neurology, Rafsanjan University of Medical Sciences, Rafsanjan, Iran.
J Res Med Sci. 2012 Dec;17(12):1156-60.
This study aims to assess the cerebral vessels flow in brain death patients with different causes, including focal and diffuse lesions and comparison of flows according to the underlying causes.
Two groups of 15 brain-dead patients one with focal and the other with diffuse brain lesions were compared according to their cerebral blood flow pattern 48 h passed brain death certification.
Bilateral absence of flow in middle cerebral artery (MCA) was found in 54.5% of brain-dead patients with diffuse lesion and 50.33% of those with focal lesions. Systolic spike pattern in MCA flow was found in 46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion. Diastole-systole separation pattern in MCA was seen in 16.65% of patients with the diffuse lesions. This pattern in MCA was not seen in patients with the focal lesion group. In carotid arteries, we did not find the absence of flow in any cases. Thirty percent of all patients in both groups had a normal flow pattern (36.6% of patients with focal lesions and 23.3% of patients with diffuse lesion). Patients with focal lesion had 33.3% systolic spike pattern flow and had 23.35% diastole-systole separation flow pattern. In intra-cranial vessels, systolic spike pattern was more common among patients with focal lesions than patients with diffuse lesion, however, this difference was not statistically significant (46.2% of patients with focal lesion and 16.65% of patients with diffuse lesion) (P value = 0.244-0.09). Diastole-systole separation flow was more common in patients with diffuse lesions than those with the focal lesions although this could not reach the significant level as the previous pattern (20% of patients with diffuse lesion versus no case in patients with focal lesion) (P value = 0.181).
Absence of flow was the most common brain flow pattern in the focal and diffuse group lesions. There was no difference in flow pattern between the focal and diffuse brain lesions groups in brain-dead patients.
本研究旨在评估不同病因脑死亡患者的脑血管血流情况，包括局灶性和弥漫性病变，并根据潜在病因比较血流情况。
两组各15例脑死亡患者，一组为局灶性脑病变，另一组为弥漫性脑病变，在脑死亡认证48小时后，根据其脑血流模式进行比较。
弥漫性病变脑死亡患者中54.5%和局灶性病变患者中50.33%出现大脑中动脉（MCA）双侧血流缺失。局灶性病变患者中46.2%和弥漫性病变患者中16.65%出现MCA血流的收缩期尖峰模式。弥漫性病变患者中16.65%出现MCA的舒张期-收缩期分离模式。局灶性病变组患者未出现MCA的这种模式。在颈动脉中，所有病例均未发现血流缺失。两组所有患者中30%血流模式正常（局灶性病变患者中36.6%，弥漫性病变患者中23.3%）。局灶性病变患者中33.3%为收缩期尖峰模式血流，23.35%为舒张期-收缩期分离血流模式。在颅内血管中，收缩期尖峰模式在局灶性病变患者中比弥漫性病变患者更常见，但这种差异无统计学意义（局灶性病变患者中46.2%，弥漫性病变患者中16.65%）（P值=0.244 - 0.09）。舒张期-收缩期分离血流在弥漫性病变患者中比局灶性病变患者更常见，尽管未达到与前一种模式相同的显著水平（弥漫性病变患者中20%，局灶性病变患者中无病例）（P值=0.181）。
血流缺失是局灶性和弥漫性病变组中最常见的脑血流模式。脑死亡患者局灶性和弥漫性脑病变组之间的血流模式无差异。
