Cerebral Arterial Compliance in Polytraumazed Patients with Cerebral Vasospasm
The purpose was to determine the status of the cerebral arterial compliance (cAC) in a concomitant head injury and cerebral vasospasm (CVS) with and without the development of intracranial hematomas (ICH). In Materials and Methods, we examined 80 polytrauma patients with severe TBI and CVS. During or immediately after dynamic helical computed tomography angiography (DHCTA), the monitoring of the transcranial Doppler of the MCA was recorded bilaterally with 2-MHz probes. The cerebral blood volumes were calculated from the DHCTA data with complex mathematical procedures using the “direct flow model” algorithm. In Results, CAC was significantly decreased (p < 0.001) in both the first and second group TBI and CVS (with or without ICH) in comparison with normal data (p < 0.001) and TBI without CVS. The cAC was significantly decreased on the side of the former hematoma with CVS than on the contralateral side with CVS (р = 0.003). In Conclusion, the cAC in TBI and CVS gets significantly lower as compared to the normal condition (p < 0.001). After removal of the ICH and development of CVS, the compliance in the perifocal zone remains much lower (р = 0.003) as compared to compliance of the other brain hemisphere.
KeywordsCerebral arterial compliance Cerebral vasospasm Intracranial hematomas Traumatic brain injury
D.B. was supported by NIH P20GM109089, DOD DM160142 and RSF No. 17-15-01263.
Conflict of Interest: We declare that we have no conflicts of interest.
- 1.Loret JE, Zemmoura I, Daumas-Duport B, Buffenoir K, Paulus J. Delayed post traumatic vasospasm leading to ischemia in a patient with mild traumatic brain injury. J Neurol Disord Stroke. 2013;1(2):10–4.Google Scholar
- 12.Avezaat CJJ. Cerebrospinal fluid pulse pressure and craniospatial dynamics. A theoretical, clinical and experimental study. Rotterdam: Erasmus University; 1984.Google Scholar
- 13.de Jong S. Quantifying cerebral blood flow of both the micro- and macrovascular system using perfusion computed tomography. Twente: The Netherlands; 2015.Google Scholar
- 14.Ikdip K. Exploring differences in vascular aging and cerebrovascular hemodynamics between older adults of White Caucasian and South Asian origin. Waterloo: Ontario; 2014.Google Scholar
- 23.Furuya Y, Hlatky R, Valadka A. Comparison of cerebral blood flow in computed tomographic hypodense areas of the brain in head-injured patients. Neurosurgery. 2003;52:340–6. https://doi.org/10.1227/01.neu.0000043931.83041.aa.CrossRefPubMedGoogle Scholar
- 29.Rey F, Li X, Carretero O. Perivascular superoxide anion contributes to impairment of endothelium-dependent relaxation: role of gp91(phox). Circulation. 2002;106(19):2497–502. https://doi.org/10.1161/01.cir.0000038108.71560.70.CrossRefPubMedGoogle Scholar