Goraj B, Rifkinson-Mann S, Leslie D R, Lansen T A, Kasoff S S, Tenner M S
Department of Radiology, New York Medical College, Valhalla 10595.
AJNR Am J Neuroradiol. 1994 Aug;15(7):1333-9.
To investigate the usefulness of transcranial Doppler ultrasonography in the evaluation of intracranial pressure changes after head injury.
Transcranial Doppler examinations and intracranial pressure measurements using intraparenchymal monitors were performed in 12 cases of closed head injury. Twenty-four sets of data, including the Glasgow Coma Scale, intracranial pressure, transcranial Doppler, and carbon dioxide pressure were compared. The side-to-side difference in the resistivity index was also assessed.
There was a significant correlation between increased pressure values and resistivity index when comparing measurements from the same side. There was no correlation between carbon dioxide pressure and any transcranial Doppler parameter or intracranial pressure measurement. No significant correlation was found between the resistivity index and the Glasgow Coma Scale. End diastolic velocity was a stronger determinant of resistivity index than peak systolic velocity.
The relationship of ipsilateral measurements of intracranial pressure to resistivity index is valid. The resistivity index must be analyzed within the context of the particular disease studied, especially with respect to the hemodynamic alterations. Initial findings suggest that intracranial pressure monitoring cannot be replaced by serial transcranial Doppler measurements in the treatment of the patient with acute head injury.
探讨经颅多普勒超声检查在评估头部损伤后颅内压变化中的作用。
对12例闭合性头部损伤患者进行经颅多普勒检查及使用脑实质内监测仪测量颅内压。比较包括格拉斯哥昏迷量表、颅内压、经颅多普勒及二氧化碳分压在内的24组数据。还评估了阻力指数的左右差异。
比较同一侧测量值时，压力值升高与阻力指数之间存在显著相关性。二氧化碳分压与任何经颅多普勒参数或颅内压测量值之间均无相关性。阻力指数与格拉斯哥昏迷量表之间未发现显著相关性。舒张末期速度比收缩期峰值速度更能决定阻力指数。
颅内压同侧测量值与阻力指数之间的关系是有效的。阻力指数必须在特定疾病的背景下进行分析，尤其是关于血流动力学改变方面。初步研究结果表明，在急性头部损伤患者的治疗中，颅内压监测不能被连续的经颅多普勒测量所取代。
